Abstract
BACKGROUND: Hydrocele of the canal of Nuck is a rare congenital condition in females that often mimics other groin masses, making accurate diagnosis challenging. Limited awareness, particularly among non-surgical clinicians, often leads to unnecessary investigations or delayed treatment. Greater recognition of this entity is crucial for timely diagnosis and appropriate management. CASE PRESENTATION: We report the case of a 6-year-old girl who presented with a painless swelling in the right inguinal region, persisting for six months. On examination, a firm, non-tender mass measuring 3 × 3 cm was noted. Ultrasonography revealed a well-defined, unilocular cystic lesion measuring 4 × 3 cm, extending through the inguinal canal into the labia majora. Surgical excision was performed, with careful dissection from the round ligament and ligation of the canal of Nuck at the deep inguinal ring. The cyst contained clear serous fluid. The patient's postoperative course was uneventful, and no recurrence was observed at three-month follow-up. CONCLUSION: Hydrocele of the canal of Nuck is an uncommon and often overlooked condition with limited representation in surgical and gynecological literature, yet it remains an important differential diagnosis for inguino-labial swelling in young females. Early clinical recognition is crucial to avoid unnecessary imaging or invasive procedures. Ultrasonography provides a reliable, non-invasive means of differentiation from other inguino-labial masses, while surgical excision remains the definitive treatment with excellent outcomes. This case underscores the importance of considering this diagnosis in young females presenting with inguino-labial swelling.