A rare extrapelvic endometriosis: inguinal endometriosis

To study the diagnosis and treatment of inguinal endometriosis.

A retrospective study was made of 9 patients presenting with inguinal endometriosis between January 1986 and November 2008.

The incidence of inguinal endometriosis was 0.07% among a total of 13,352 patients with endometriosis treated. Eight of 9 patients (88.9%) had lesions on the right side. The symptoms in 6 patients fluctuated with menses. Only in 3 of them with cyclic symptoms was inguinal endometriosis suspected preoperatively. Symptomatic complaints ranged from 3 months to 10 years, with an average interval of 3 years. Eight patients received complete excision of inguinal lumps. One patient with a lump of 5 cm in diameter underwent a wide excision including the extraperitoneal portion of the round ligament. Four cases underwent pelvic exploration at the same time, and it revealed the coexistence of ovarian endometriomas. No one showed recurrence in the groin on follow-up of 19-96 months.

Inguinal endometriosis is rare and often diagnosed accidentally. It is mostly right-sided and concomitant with pelvic endometriosis. The surgical procedure is complete excision of the mass. Pelvic exploration should be performed if necessary.