Female Hydrocele: A Rare Case of a Cyst of the Canal of Nuck in an Adult Woman

The cyst of the canal of Nuck, also known as a female hydrocele, is an uncommon anomaly caused by the incomplete obliteration of the processus vaginalis in females during fetal development. Because its presentation is nonspecific and resembles other groin pathologies, it is frequently misdiagnosed. We report the case of a 33-year-old woman with a gradually enlarging, mildly painful swelling in the left groin. Imaging revealed a well-defined fluid-filled structure located within the left inguinal canal, which was removed through an open anterior approach, as it provides direct anatomical exposure of the cyst and surrounding inguinal structures. Intraoperatively, a bluish, fluid-filled cyst attached to the round ligament was identified. Histopathological analysis confirmed a cyst of the canal of Nuck lined by mesothelial cells. The postoperative recovery was uneventful, with no recurrence during follow-up. This report underscores the need to include this rare lesion in the differential diagnosis of female groin swellings. Ultrasound is the first-line imaging method; CT scan and MRI are also helpful for the preoperative assessment, facilitating accurate diagnosis and optimal surgical planning. Open anterior excision is the definitive, safe, and effective surgical approach for canal of Nuck cysts, offering excellent outcomes and minimal risk of recurrence.