A Canal of Nuck Cyst Presented as a Femoral Hernia: A Rare Case Report With Diagnostic Dilemma

Abstract

A cyst of the canal of Nuck is an uncommon disorder in females. It results from the failure of obliteration of the peritoneal fold that runs along the round ligament. This case report details a unique and rare presentation of a 38-year-old female who presented with a right groin swelling. Although her preoperative images showed only the right canal of the Nuck cyst, the intraoperative diagnosis was established as a femoral hernia containing a canal of the Nuck cyst. She underwent an elective cyst excision with repair of the femoral hernia. She had an uneventful post-operative recovery. A femoral hernia that contains a cyst of the canal of Nuck is a rare manifestation of this uncommon condition. The most effective treatment options are surgical cyst excision and repair of the femoral hernia.

Keywords: complex cyst; endometriosis; female gender; femoral hernia; the canal of nuck.

Figure 1. MRI pelvis showing complex cyst at the region of the canal of Nuck (orange arrow) with no evidence of femoral or inguinal hernia

Figure 2. CT abdomen and pelvis showing a cystic lesion in the right femoral region (orange arrow) with no femoral or inguinal hernia

Figure 3. Intraoperative findings of the canal of Nuck cyst (blue arrow) passing below the inguinal ligament (green arrow) toward the femoral canal