Extra-Inguinal Round Ligament Endometriosis Near to Pubic Bone. Report of a Case

Abstract

Endometriosis is a chronic, oestrogen-dependent condition, defined as extra-uterine, functional endometrial tissue. We report a case of endometriosis of extra-inguinal part of the round ligament, in near proximity to pubic bone. To our knowledge, this is the first case report in the searched English literature. A 31-year-old female patient, nullipara, presented with an unrelated to menstruation, right suprapubic painful swelling of 6 months duration. Her medical history was free. The patient has been receiving contraception for the last 3 years. Colour Doppler and computed tomography showed a spindle-shaped lobe, of inhomogeneous echomorphology, with dimensions of 2.77 × 1.29 cm and relative contamination, which appeared in continuation with the ipsilateral rectus abdominis muscle. Intraoperatively, under general anaesthesia, a mass of the right round ligament of the uterus was found in the ligament’s insertion to the pubic bone. The extra-inguinal part of the right round ligament was excised and the intra-pelvic part was sutured to the ground of the inguinal canal. The histological and immunohistochemical characteristics of the specimen were consistent with endometriosis. Her recovery was uneventful and the patient was discharged on the 2nd postoperative day. Endometriosis of the round ligament of the uterus, should be taken into consideration in the differential diagnosis in cases of extra-inguinal swelling in women of childbearing ages, even in cases with a free medical history.