CASE REPORT   

Il Giornale Italiano di Radiologia Medica 2018 Settembre-Ottobre;5(5):646-50

DOI: 10.23736/S2283-8376.18.00126-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Cyst of Nuck’s duct: a rare cause of swelling in the inguinal region

Matteo MASTROROSATO ✉, Ginevra DANTI, Antonio L. ANNESE, Michele PIETRAGALLA, Patrizia SOTTILI, Vittorio MIELE

SOD Radiodiagnostica di Emergenza Urgenza, Dipartimento dei Servizi, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italia

The Nuck canal is an extroflexion of the parietal peritoneum which in the female represents the equivalent of the male peritoneo-vaginal duct. The hydrocele of the Nuck duct derives from the lack of distal obliteration of the peritoneo-vaginal duct, the Nuck cysts derives from the missed obliteration of a section of the duct and does not communicate with the peritoneal cavity; both are rare causes of inguinal swelling in young women. The ultrasound diagnosis of Nuck cysts is often difficult due to its rarity: the differential diagnosis includes numerous pathologies including inguinal hernia, Bartolini’s gland cysts, aneurysms, lymphadenopathy, lymphoceles, tumor masses. Magnetic Resonance Imaging (MRI) can characterize the lesion and discard other possible diagnoses. Communication with the peritoneum makes it possible to distinguish the hydrocele from the Nuck cyst. We report a case of a 46-year-old woman who showed up at our Radiology Department complaining for months of a palpable tumefaction at the left ileopubic branch. The patient undergoes ultrasound examination of the inguinal region which demonstrates an anechoic formation with an elongated morphology. Subsequently is performed a contrast-enhanced MRI that shows a hyperintense fluid formation in T2-wieghet sequence with regular walls and linear postcontrastographic impregnation that extends up to the labia majora and which seems in communication with the peritoneal cavity. A second preoperative ultrasound check is performed five months later, showing a slight reduction in size of the lesion.

KEY WORDS: Cysts - Magnetic resonance imaging - Vagina