Inguinal endometriosis connected to intraperitoneal round ligament: Complete excision with extraperitoneal wide dissection / 대한산부인과학회지

Inguinal endometriosis is a rare gynecologic disease. A 43-year-old woman had felt small nodular mass, which causing cyclic groin pain and fluctuation with menstrual cycle. CT scan revealed the extraperitoneal inguinal mass connected to the left round ligament. During the operation, infiltrative fibrotic mass around the inguinal mass could only be excised with wide groin dissection. After dissection of the abdominal muscles, the intraperitoneal mass could be pulled out and excised at the level of the intact round ligament. Histological diagnosis at the excised mass was endometriosis. After the surgery, the pain disappeared completely. We have reviewed published articles concerning inguinal endometriosis. The mechanism of development of inguinal endometriosis seems to be to that of indirect hernia with a difference of disappearing hernia sac resulting from inflammation of endometriosis. About half of the patients revealed periodicity such as cyclic pain or fluctuation of pain with menstral cycle. We describe the complete surgical excision of extraperitoneal inguinal endometriosis connected to round ligament endometriosis. Successful treatment can be achieved with understanding of the pathophysiology and anatomy related to the inguinal endometriosis.

A Case of Primary Malignant Melanoma of Posterior Vaginal Fornix / 대한산부인과학회잡지

Primary malignant melanoma of the vagina is a very rare disease with incidence of 0.026 per 100,000 women. The opinion of several types of treatment is suggested but the prognosis is extremely poor. Although malignant melanoma is generally regarded as a radioresistant tumor, recent reports show that definitive irradiation with high-dose fractionation regimen demonstrates high response rates in primary and metastatic lesions. A case of primary malignant melanoma of the vagina which was treated with intensity-modulated radiation therapy is presented with a brief review of concerned literature.