Presentation
A painless bulge in the right inguinal and labial regions for the last 3 to 4 years. Gradually increasing in size.
Patient Data
There is a well-defined lesion in the right inguinal region extending towards the right labia. The lesion is aligned to the right inguinal canal. Its proximal/ lateral end lies near the deep inguinal ring level. The distal/ medial end overlies the pubic symphysis. The inguinal canal contents are displaced posteriorly. The lesion shows a thin capsule and measures about 138 (length) x 78 (width) x 50 (anteroposterior) mm. It is hypoechoic with internal linear incomplete striations without cystic changes/ calcification. Very few internal flow signals are present showing arterial type flow. The lesion is compressible.
There is no right inguinal hernia.
1st photo shows a large bulge in the right inguinal region reaching to the right labia. The gross specimen shows a capsulated fat-containing lesion.
Case Discussion
An elderly female presented with a gradually increasing painless lesion in the right inguinal and labial regions. The ultrasound was requested for the lesion characterization and to rule out an inguinal hernia. Ultrasound features favor a lipoma. The lesion alignment to the inguinal canal favors the intracanal location. However, the extent of the lesion was beyond the inguinal canal.
Surgical excision was done. It was an encapsulated lipoma outside the inguinal canal. Histopathology revealed the tumor composed of mature adipocytes without lipoblasts favoring lipoma.
Surgical follow-up and photos courtesy: operating surgeons Dr. Drashti Patel and Dr. Amar Vakhariya.
Histopathology report courtesy: pathologist Dr. Divya P. Naik