Abstract
Hydrocele of the canal of Nuck, also called the “female hydrocele,” is a rare developmental disorder in females. This entity is now believed to be more common now in comparison with previous reports; however, it is still an unfamiliar problem for physicians. The processus vaginalis accompanies the round ligament through the inguinal canal into the labium majus. This evagination of the parietal peritoneum forms the canal of Nuck in the female. The canal of Nuck normally loses its connection with the peritoneal cavity during the first year of life, but can result in a hernia or hydrocele when the connection of the canal of Nuck fails to close. Here, we present the case of a 43-year-old female who complained of swelling in the right inguinal region. Coronal and axial magnetic resonance imaging (MRI) revealed a cystic mass lesion with an irregular shape in the right inguinal region, and smaller cystic lesions extending alongside the right round ligament were also identified in the right side of the pelvic cavity. Magnetic resonance (MR) hydrography revealed the uninterrupted cystic lesion from the inguinal region to the pelvic cavity, with constrictions at the internal and external inguinal rings. These MR findings proved to be incredibly useful for surgical planning.
Highlights
A hydrocele of the canal of Nuck is the female equivalent of a spermatic cord hydrocele in males; this entity is called the “female hydrocele” [1, 2]
We present a case of a hydrocele of the canal of Nuck diagnosed with magnetic resonance (MR) hydrography, a useful technique that allowed us to evaluate the extension of the hydrocele from the inguinal region into the pelvic cavity
Maximum intensity projection (MIP) imaging of Magnetic resonance (MR) hydrography showed that the right inguinal cystic mass lesion and the intrapelvic cystic lesion together formed an uninterrupted cystic lesion measuring 13.5 cm in diameter, with constrictions at the internal and external inguinal rings (Fig. 2)
Summary
A hydrocele of the canal of Nuck is the female equivalent of a spermatic cord hydrocele in males; this entity is called the “female hydrocele” [1, 2]. Maximum intensity projection (MIP) imaging of MR hydrography showed that the right inguinal cystic mass lesion and the intrapelvic cystic lesion together formed an uninterrupted cystic lesion measuring 13.5 cm in diameter, with constrictions at the internal and external inguinal rings (Fig. 2) These findings seemed to indicate that the lesion was either a hydrocele of the canal of Nuck or endometriosis due to the minimal internal hemorrhagic component. A reddish mass lesion was found on the intracystic wall on gross pathologic examination, there was no evidence indicative of malignancy or endometriosis These findings indicated that further surgery was not required for the remaining lesion, and a final diagnosis of hydrocele of the canal of Nuck was made. No recurrence of a mass in the inguinal region has occurred
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