An Inguinal Endometriosis without Any Other Pelvic Endometriosis Mimicking Direct Inguinal Hernia: A Case Report

Inguinal endometriosis is a rare disease. Patients with inguinal endometriosis usually exhibit cyclic inguinal pain with a cyclic change in the size of the inguinal mass. It is more often found on the right side and commonly accompanies concomitant endometriosis lesions on pelvic organs or peritoneum. We report a case of inguinal endometriosis without any of the usual characteristics. A 48-year-old with non-severe dysmenorrhea and pelvic pain presented a left inguinal mass, palpable only when standing. Under the impression of direct inguinal hernia, laparoscopic herniorrhaphy was performed. Intraoperative laparoscopic findings revealed no other endometriosis lesion on the pelvic organ or in the abdominal cavity, and the histopathologic report confirmed it was endometriosis. Thorough inspection and excision of endometriosis lesions in the pelvic cavity are crucial for treatment. Therefore, an appropriate surgical plan following accurate preoperative diagnosis is important. If the intraoperative evaluation of endometriosis was not enough, postoperative gynecologic assessment is strongly recommended.