腹腔鏡下アプローチにより切除した鼠径部子宮内膜症の一例

抄録

　Inguinal endometriosis is very rare, and a percutaneous approach is predominantly used for surgical resection. Here, we report a case of laparoscopic excision for inguinal endometriosis.

　A 50-year-old female patient was treated with dienogest for endometriosis by her previous physician, who referred her to our hospital because of pain and mass sensation in the right inguinal region. She had right inguinal region tenderness, and transabdominal ultrasonography revealed a 13×11 mm echogenic free space in the same region. A blood test revealed a CA125 level of 13.9 U/ml, while a magnetic resonance imaging scan showed a hematoma-like mass, approximately 10 mm in diameter, inside the femoral arteriovenous vein in the right inguinal region, leading to the diagnosis of right inguinal endometriosis. Additionally, she had uterine fibroids and a left ovarian endometriotic cyst and thus simultaneously underwent a total laparoscopic hysterectomy, right oophorectomy, left salpingo-oophorectomy, and right inguinal mass resection in the Department of Surgery. The round ligament in the right inguinal canal was expanded peripherally, and an approximately 1 cm mass lesion in the right inguinal region was excised. The specimen was pathologically diagnosed as endometriosis. Reportedly, 91% of patients with inguinal endometriosis had intraperitoneal endometriosis. Therefore, intraperitoneal endometriosis should be considered on diagnosis of inguinal endometriosis, and a laparoscopic approach may be effective for surgical resection.