A Woman’s Groin Lump Behaved Exactly Like a Hernia, but Surgeons Traced It to a Passage That Should Have Closed in Infancy

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Surgeons at Redcliffe Hospital in Queensland, Australia, traced the swelling to the canal of Nuck, a tiny passage in female anatomy that is supposed to seal shut in the first year of life. Hers had stayed open and filled with fluid, forming what doctors call a hydrocele of the canal of Nuck. The team described the case in the Journal of Surgical Case Reports in January 2026, calling it “a rare but important differential for a woman with a groin lump.”

The canal is named after Anton Nuck, a Dutch anatomist who described it in 1691. It is a small pouch of the abdominal lining that travels alongside the round ligament, a band of tissue that runs from the uterus through the groin toward the labia majora.

In males, the matching structure is the processus vaginalis, the channel that lets the testes descend into the scrotum. Boys whose channel fails to close can develop hydroceles and hernias, and the same thing can happen in girls. The reference site Radiopaedia notes that an open canal can lead to either an inguinal hernia or a hydrocele, and can also give endometriosis a path into the groin.

The Australian authors note that these problems show up mostly in young girls and only rarely in adult women. Groin hernias themselves are far less common in women: the National Institute of Diabetes and Digestive and Kidney Diseases says men are 8 to 10 times more likely than women to develop an inguinal hernia.

When doctors examined the woman, they found a mildly tender, fluid-filled lump over the right superficial inguinal ring, the outer opening of the groin canal. One classic hernia clue was missing: the lump did not bulge when she coughed. There was no swelling on the other side and no enlarged lymph nodes.

A CT scan taken while she strained showed a two-lobed cyst passing through the inguinal ring. The part inside the abdominal lining measured about 46 by 35 by 33 millimeters. The part in the groin canal stretched about 76 millimeters long. No bowel or other abdominal contents had pushed through, which pointed to a hydrocele, not a hernia.

The authors say that distinction matters because canal of Nuck abnormalities can be mistaken for inguinal hernias, leiomyomas (benign smooth-muscle tumors) or cancer that has spread to lymph nodes. Ultrasound is widely available, they note, but has limits in evaluating deeper structures. CT or MRI can help, and CT is often preferred because it is cheaper and easier to get.

A 2020 report on six adult cases treated at Charité hospital in Berlin, published in the Journal of Clinical Medicine, described a similar diagnostic problem. The patients, aged 29 to 44, included several with long pain histories and repeated outpatient visits before they were diagnosed. The Berlin authors warned that ultrasound findings can go unrecognized “if the examiner is not familiar with the possibility.”

The surgeons used a laparoscopic transabdominal preperitoneal (TAPP) approach, a keyhole operation done from inside the abdomen that is commonly used to repair groin hernias. They found the hydrocele just inside the inferior epigastric blood vessels, pulled it back into the abdomen, separated it from the round ligament and removed it.

Removing the sac left a clearly visible weak spot, so they reinforced the area with a 12 by 16 centimeter mesh. In their words, the defect “would be expected to develop into a hernia if left untreated.” The authors added that the TAPP view also helps surgeons spot a hidden hernia on the same side.

Lab analysis showed only normal lining cells and mature fat, with no sign of cancer. The woman went home the same day. At her six-week follow-up, her symptoms had fully resolved, and apart from some early pain after surgery, she had no complications.

This is a single case report, so it cannot show how common the condition is in adult women or which operation works best. The authors acknowledge there are no studies directly comparing open and laparoscopic surgery for this problem. Their preference for keyhole surgery is borrowed from hernia research, which links laparoscopy to less pain and faster recovery.

Other recent reports show how these cases can overlap with true hernias. A February 2026 case in Cureus described a 62-year-old woman with two months of painful right groin swelling. Ultrasound identified a canal of Nuck cyst, and surgeons removed it robotically while repairing hernias in both groins, including a femoral hernia.

Most groin lumps in women have common explanations, and no single case changes that. People with a new, growing or painful groin swelling should see a clinician, who can decide whether imaging is needed.

It is a small pouch of abdominal lining that runs through the female groin with the round ligament. It normally closes within the first year of life.

No. CT showed a fluid-filled sac, or hydrocele, with no abdominal contents inside, even though it behaved like a hernia.

Removing the sac left a visible gap that the authors said would be expected to become a hernia if left untreated, so they reinforced it.

The condition is rare in adults and can look like a hernia, a benign tumor or swollen lymph nodes. Ultrasound findings can also be overlooked by examiners unfamiliar with it.

Should women with groin lumps worry about this condition?

It is uncommon, and most groin lumps have more routine causes. A new, enlarging or painful lump should be checked by a clinician.