Abstract
A 43-year-old woman was seen at the hospital because of an about 10-year history of swelling at the right side of the pubic bone which had been increasing in size with menstrual pains. When she was first seen, an irregular-shaped, hard submucosal tumor about 5cm in diameter was present in the right side of the pubic bone. Serum CA125 level increased to 72 (U/ml). Ultrasonic study showed a 39.6×23.5×32.3mm hypoechoic area with irregular margin. Abdominal CT scan visualized a heterogeneously enhanced irregular tumor shadow from the right inguinal region to the anterior surface of the pubic bone. Based on her clinical course, ectopic endometriosis was the most likely diagnosis and aspiration biopsy cytology (ABC) of the tumor confirmed the diagnosis of endometriosis. According to her desire, surgical therapy was performed. The tumor had connected to the anterior surface of the pubic bone from the round ligament, and then the tumor with the round ligament was removed. The tumor was 5.5×5×4cm in size and elastic-hard with irregular margin, and the section was solid. Pathological study demonstrated endometrial glands with endometrial stroma in the fibrous tissues, and endometriosis was diagnosed. There has been no recurrence as of 1 year after the operation.
We consider that the patient interview is most important to make the diagnosis of the disease and it must be included in differential diagnoses of inguinal hernia. Besides surgical therapy, other treatments can carry good prognosis to the patient, so that preoperative ABC could be the preoperative examination of choice.
