Inguinal ovary in adult women-case report and literature review
© Josefsson et al.; licensee Springer. 2013
Received: 23 September 2013
Accepted: 7 October 2013
Published: 17 October 2013
This paper describes a rare finding of an inguinal ovary in an adult woman who presented with pelvic pain. Inguinal ovary may occur if the gubernaculum fails to attach to the uterus or if the canal of Nuck remains open during fetal development.
Ovary within the inguinal canal is occasionally seen in infants, but is rare in adult women. This paper describes a woman with an inguinal ovary who presented with pelvic pain. We review the literature and discuss its embryological background.
A literature search revealed twelve case reports in adults. The majority presented with a palpable groin mass and they were diagnosed at time of surgery for suspected bowel hernia (Tagliaabue ; Machado & Machado ; Mandel et al. ; Alzaraa ). One woman presented with pelvic pain and was found on laparoscopy to have a rudimentary uterine horn and ovary herniating through the inguinal canal (Al Omari et al. ). Coexisting mullerian and renal malformations have been described (Alzaraa ; Al Omari et al. ).
Male and female reproductive systems share common steps in early development. Understanding this helps to comprehend the causes of inguinal ovary. The gonads develop from mesothelium on the urogenital ridge. Initially in both male and female, the gonads are situated posterior in the abdominal cavity. After sex differentiation both ovaries and testes descend, but to varying extent. The testes descend to the scrotum via the gubernaculums, a caudal remnant of the mesonephric duct that passes through the abdominal wall to the labioscrotal swelling. As the embryo grows the gubernaculums remains the same size causing the testes to be situated progressively lower down. By the eight month the testes have reached the scrotum and by birth the processus vaginalis at the internal inguinal ring closes.
Contrary to the testes, the ovary descends to a lesser extent because the gubernaculums adheres to the uterus, thus preventing movement. If the gubernaculum fails to attach, the ovary may descend through the inguinal canal. The canal of Nuck is a pouch of peritoneum, analogous to the processus vaginalis in males, which follows the round ligament from the ovary to the labia via the inguinal canal. This canal closes within the first year of life. If it fails to close a hernia may form.
This paper describes a rare case of inguinal ovary in a woman who presented with pelvic pain. An inguinal ovary may occur if the gubernaculum fails to attach to the uterus in fetal life or if the canal of Nuck remains open after birth.
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
We acknowledge the patient who the case report is based on. The patient did not receive any financial compensation.
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