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Inguinal endometriosis (IE) secondary to involvement of the extraperitoneal portion of the round ligament is a rare condition, occurring in <1% of patients with endometriosis. It is often confused with other inguinal pathology and mostly diagnosed on histological examination.1 The first case was described by Allen in 1896. Since then only individual cases or small series have been reported.2
In this study, we report a retrospective clinicopathological review of 42 cases of pathologically proven IE, collected from seven institutions, which is to the best of our knowledge the largest series ever published.
Methods and results
The surgical pathology databases of seven institutions were searched for endometriosis. Only non-cutaneous and non-lymph node IE was included. The clinical information was extracted from the surgical operating notes. Frozen section was requested in only one case and was diagnostic for endometriosis. Fine needle aspiration (FNA) was made in one other patient and was reported as ‘suspicious for malignancy’.
Included in the study were 42 patients (three were pregnant) with a mean age of 35 years (range 20–53 years). Eleven lesions were located on the left side, 29 on the right side and the location was unknown in the remaining two. Five patients had a prior history of endometriosis involving vagina, peritoneum, ovary and inguinal area. Presenting symptoms included groin lump (sometimes painful), periodic menstrual tenderness, hernia and cyst.
The endometriosis was suspected preoperatively in 13 cases, …