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Abstract
Introduction/Background The processus vaginalis is an invagination of the parietal peritoneum that descends anterior to the gubernaculum and is shorter in females than in males. The superior part of the processus vaginalis obliterates at or soon before birth, and this obliteration continues caudally until the entire structure vanishes during the first year of life. When there is a partial or total failure of obliteration of this processus vaginalis, the canal of Nuck forms as a potential space.
Methodology We present the case of a 39-year-old woman was referred to our gynaecological department with the diagnosis of a Bartholin’s cyst. Three years ago she had undergone surgery for the same diagnosis, complicated with important hematoma. The patient presented with a painless vulval swelling, that gradually became conspicuous, bothering his sexual activity.
Results On physical examination, a soft fluctuant sausage-shaped mass was found, measuring approximately 5 cm, extending to the all labia majora. There were no signs of infection or inflammation and the overlying skin had no lesions. Ultrasound revealed a well-defined hypoechoic elongated mass with 4.5 cm of long axis, septated, extending into labia majora. Sonographic findings were consisting with the diagnosis of a cyst of the canal of Nuck and treatment choices were discussed with the patient. She opted for surgical excision to avoid the possibility of a recurrence associated with aspiration treatment.
Conclusion The cysts of Canal of Nuck encompass various differential diagnoses, including lymph node, cyst, inguinal hernia, infection/abscess, inguinal gonad, endometriosis, benign tumors, and neoplasia. A thorough understanding of these masses’ anatomy, clinical presentation, and imaging characteristics can help avoid misdiagnosis and inappropriate treatment. Surgical intervention is considered the gold standard for managing symptomatic masses in the canal of Nuck. In some cases, conservative management with close observation may be appropriate, especially in asymptomatic or low-risk lesions.
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