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Canal of Nuck Cyst

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Canal of Nuck cyst MRI and CT findings
Canal of Nuck cyst MRI and CT

Pathophysiology of the Canal of Nuck

  • Extension of the parietal peritoneum follows the round ligament as it passes to the inguinal canal.
  • Usually gets obliterated.
  • This evagination of the parietal peritoneum =  the canal of Nuck =  female counterpart of processus vaginalis in men.
  • If it is:
    • Completely patent: Avenue for an indirect inguinal hernia and hydrocele (Canal of Nuck hernia).
    • Obliterated at the level of both the superficial and deep inguinal rings: Fluid may be trapped in between both ends of the canal, creating a Canal of Nuck cyst.
    • Obliterated at lower end – Infantile hydrocele / encysted hydrocele.
  • Hydrocele vs cyst canal of Nuck : The terms hydrocele and cyst of Canal of Nuck are used interchangeably but these are separate pathologies.
  • Symptoms: It usually presents as a painless swelling in the inguinal region. Infection can cause pain.

Imaging appearances:

  • Canal of Nuck cyst is an inguinal cyst in females.
  • US : Cystic lesion in the inguinal canal with posterior acoustic attenuation.
  • CT : Hypodense lesion with our without internal septations.
  • MRI: T1 isointense, T2 hyperintense, typical appearance of a cystic lesion.
  • Can show peripheral enhancement.

Differentials for Canal of Nuck cyst

  • Inguinal hernia containing fluid in patients with ascites.
  • Soft tissue tumor.
  • Endometriosis cyst
  • Cyst
  • Abscess
  • Lymphadenopathy

Management:

Surgical excision or conservative management depending on patient presentation.

Detailed video with PACS based case images:

Canal of Nuck Cyst CT and MRI findings
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