A 45 year old lady presented in OPD with swelling in bilateral inguino-labial region for last three months .There was no history of Diabetes, hypertension, any cardiac ailment, urinary tract infection, trauma or any infection in this region. On examination: The swellings were globular, cystic in consistency, not tender, about 4x2 cm on left side and 3x2 cm on right side.
Her USG showed lobulated, thick walled cystic lesions, few of which showing internal echos, seen in bilarteral inguinal regions measuring approximately 20x28mm on left side and 18x34mm on right side. ?Lymphangioma/Round ligament Cyst.MRI showed lobulated tubular fluid signal intensity lesions in left pelvic inguinolabial and right inguinolabial regions extending along the round ligaments suggestive of hydrocele of canal of Nuck/ Mesothelial cysts of the round ligament.
Laparoscopic excision of hydrocele of canal of Nuck on both sides with transabdominal preperitoneal repair was done.Her histo -pathological report revealed loose connective tissue with mesothelial lining with mild chronic inflammatory infiltrate, congestion of blood vessels and fibrosis suggestive of Bilateral hydrocele of canal of Nuck.
A 35 year old lady presented in OPD with swelling left Inguino-labial region for last 4-5 months. Earlier 2ml fluid was aspirated from it for FNAC. There is no history of DM, HT or any cardiac ailment. She is a known case of Hyperthyroidism .On examination it was a diffuse (not very prominent because size has reduced after aspiration) cystic swelling in left inguino-labial region.
USG showed left sided inguinal cystic mass of 1.6x0.8cm size with clear fluid inside and no communication with the peritoneum. There was no change with the Valselva maneuver. Most likely Hydrocele of canal of Nuck.FNAC shows average cellular smear predominantly acellular necrotic material along with cyst macrophages and inflammatory cells- suggestive of cystic nature of swelling MRI Pelvis showed fluid in the inguinal canal from deep to superficial inguinal ring-possibility of Hydrocele of canal of Nuck.
Laparoscopic exicision of Hydrocele of canal of Nuck along with mesh repair was done. Histopathology showed loose connective tissue with congestd blood vessels and denuded ill defined mesothelial lining. Focal mild chronic infiltrate, fibrosis and edema suggestive of Hydrocele of canalof Nuck