Hydrocele of the canal of Nuck
Painful palpable mass in the left inguinal region and reddish swelling of the labium majus
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The T1-images show a rather thick-walled blind ending comma-shaped hypointense mass in the left inguinal area, with a blunt ending distally and extending into the peritoneal cavity proximally along the route of the round ligament.
The T2-images show mixed cystic content of the inguinal mass, it does not appear purely cystic.
The hydrocele is extending towards the labium majus. The post-contrast acquisition demonstrates mild enhancement of the wall of the hydrocele.
The surgeon decided to treat conservatively with antibiotics, and the swelling gradually decreased. Follow-up after 1 year showed complete resorption of the hydrocele.
Superadded infection of the hydrocele is most likely the cause of the wall thickening and enhancement in this case; in most cases, hydroceles have thin walls. The hydrocele does not look purely cystic on the T2-images, this might be due to some intraluminal debris caused by the infection.