Presentation
Female patient presented with a palpable mass in her right inguinal region which was noticed 1 week prior.
Patient Data
There is a cystic structure in the right inguinal area seen medially to pubic bone measuring about 5.2 x 3.2 x 1.3 cm with internal mobile debris and few mural avascular nodules of fat echogenicity without evidence of underlying abdominal wall defect or change by Valsalva, with no sonographic signs of inflammation.
Features are most likely in keeping with hydrocele of the canal of Nuck, however, the presence of internal fat content requires exclusion of being hernia of Nuck (though no clear peritoneal connection or change in Valsalva.
Case Discussion
Incomplete obliteration of the canal of Nuck can result in a hydrocele. The canal of Nuck is an abnormal patent pouch of peritoneum extending anterior to the round ligament of the uterus into the labium majus.
It's a rare condition but it should always be considered in differential diagnosis of cystic inguinal lumps in women. Ultrasound shows a thin walled, well defined, echo free cystic structure but the perfect diagnosis is given by MRI.
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