Primary inguinal subcutaneous endometriosis accompanied with an inguinal hernia: A case report

RATIONALE: We report a case with inguinal subcutaneous endometriosis without typical cyclic dysmenorrhea and accompanied with a hernia sac treated with resection of the tumor and herniorrhaphy. PATIENT CONCERNS: A 40-year-old woman had a painless enlarged inguinal nodule for 3 months. DIAGNOSES: Subcutaneous endometriosis accompanied with a hernia sac. INTERVENTIONS: Ultrasonography showed a hypoechoic lesion (3.0 cm × 2.0 cm), and an inguinal subcutaneous tumor was first suspected. After surgical exploration, a cystic lesion was excised and the hernia hole was repaired by herniorrhaphy. The immunohistochemical analysis of the small endometriotic cyst-like lesion revealed calretinin (-) in epithelial cells and CD10 (+) in stromal cells, indicative of subcutaneous endometriosis accompanied with a hernia sac. OUTCOMES: The patient was followed up for 1 year and without recurrence. LESSONS: Cutaneous endometriosis accompanied with a hernia sac can be presented without typical endometriosis-associated symptoms such as dysmenorrhea. Inguinal endometriosis might be the differential diagnosis of inguinal painless nodules.