Case of the Week # 140 Rodolpho Lambruschini, MD March 24 - April 7, 2005Buenos Aires, Argentina This is a woman who presented for a routine antenatal scan. These are images of the genitalia of the female fetus. The second image is tangential to the structure in the first. View the Answer Hide the Answer Answer This is a woman who presented for a routine antenatal scan. These are images of the genitalia of the female fetus. The second image is tangential to the structure in the first. A diagnosis of labial hydrocele [hydrocele of Canal of Nuck] was made, the cause for which was not known. These are the postnatal photographs: A similar photograph demonstarting labial hydrocele is seen in another fetus who had congenital cytomegalovirus infection: Hydrocele of the canal of Nuck is not a very commom disorder and is one of the differentials of an inguinal mass seen in a female fetus. The canal of Nuck is formed by a small evagination of parietal peritoneum or processus vaginalis which is patent in the fetus, but soon obliterates. Its failure to obliterate may result in an hydrocele or a hernia. Hydrocele of the canal of Nuck has been described to be the female counterpart of the spermatic cord hydrocele in the male. The fetus may present with a non-tender, fluctuant mass right from birth and extending from the inguinal region into the ipsilateral labium majus. Rarely, it is known to be bilateral. A rare complication noted in literature of this entity is infection of the hydrocele. Surgical excision of the hydrocele is the treatment of choice.References:1. Anderson CC, Broadie TA, Mackey JE, Kopecky KK. Hydrocele of the canal of Nuck: ultrasound appearance. Am Surg. 1995 Nov;61(11):959-61. 2. Schneider CA, Festa S, Spillert CR, Bruce CJ, Lazaro EJ.Hydrocele of the canal of Nuck.N J Med. 1994 Jan;91(1):37-8.3. Stickel WH, Manner M. Female hydrocele (cyst of the canal of Nuck): sonographic appearance of a rare and little-known disorder.J Ultrasound Med. 2004 Mar;23(3):429-32.4. Ameh EA, Garba ES.Infected hydrocoele of the canal of Nuck in a neonate. Urol Int. 2003;71(2):226-7. Discussion Board Start a discussion about this case Add to Favorites Favorite