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Ectopic Ovary
Hank Baskin, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Inguinal ovarian hernia, canal of Nuck hernia
            • Definitions

              • Ectopic ovary: Abnormally located ovary
                • Inguinal ovarian hernia (95%): Presents as labial mass
                • Intraabdominal ectopia: Incidental or iatrogenic
                  • Nonstandard ovarian location is common & usually incidental (due to long ovarian ligaments)
                  • Nonpelvic location is sometimes seen after numerous or complex abdominopelvic surgeries
                  • Ovarian transposition is sometimes performed to preserve fertility prior to radiation therapy
                • Retroperitoneal location is extremely rare

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Rosa F et al: How embryology knowledge can help radiologists in the differential diagnosis of canal of Nuck pathologies. Radiol Med. 126(7):910-24, 2021
                                      2. Morabito G et al: A young girl with right ovarian torsion and left ovarian ectopy. Ital J Pediatr. 46(1):51, 2020
                                      3. Chan D et al: Canal of Nuck hernias. Acta Radiol Open. 8(12):2058460119889867, 2019
                                      4. Jedrzejewski G et al: Nuck canal hernias, typical and unusual ultrasound findings. Ultrasound Q. 35(1):79-81, 2019
                                      5. Thomas AK et al: Canal of Nuck abnormalities. J Ultrasound Med. 39(2):385-95, 2019
                                      6. Turkgeldi L et al: Laparoscopic ovarian transposition and ovariopexy for fertility preservation in patients treated with pelvic radiotherapy with or without chemotherapy. Facts Views Vis Obgyn. 11(3):235-42, 2019
                                      7. Arian SE et al: Ovarian transposition: a surgical option for fertility preservation. Fertil Steril. 107(4):e15, 2017
                                      8. Castro AD et al: Ectopic ovary with torsion: uncommon diagnosis made by ultrasound. Radiol Bras. 50(1):60-1, 2017
                                      9. Moawad NS et al: Laparoscopic ovarian transposition before pelvic cancer treatment: ovarian function and fertility preservation. J Minim Invasive Gynecol. 24(1):28-35, 2017
                                      10. Sameshima YT et al: The challenging sonographic inguinal canal evaluation in neonates and children: an update of differential diagnoses. Pediatr Radiol. 47(4):461-72, 2017
                                      11. Karadeniz Cerit K et al: Inguinal hernia containing uterus, fallopian tube, and ovary in a premature newborn. Case Rep Pediatr. 807309, 2015
                                      12. Kollia P et al: True ectopic ovary in the right iliac fossa mimicking acute appendicitis and associated with ipsilateral renal agenesis. J Obstet Gynaecol Res. 40(3):858-61, 2014
                                      13. Webb JB et al: The management of an ectopic ovary in the inguinal canal: literature review and discussion. Pediatr Surg Int. 30(10):1075-8, 2014
                                      14. Yang DM et al: Ultrasonographic diagnosis of ovary-containing hernias of the canal of Nuck. Ultrasonography. 33(3):178-83, 2014
                                      15. Aydin R et al: Gray-scale and color Doppler ultrasound imaging findings of an ovarian inguinal hernia and torsion of the herniated ovary: a case report. Pediatr Emerg Care. 29(3):364-5, 2013
                                      16. Cascini V et al: Irreducible indirect inguinal hernia containing uterus and bilateral adnexa in a premature female infant: report of an exceptional case and review of the literature. J Pediatr Surg. 48(1):e17-9, 2013
                                      17. Irtan S et al: Ovarian transposition in prepubescent and adolescent girls with cancer. Lancet Oncol. 14(13):e601-8, 2013
                                      18. Demirel F et al: Inguinal ovary as a rare diagnostic sign of Mayer-Rokitansky-Küster-Hauser syndrome. J Pediatr Endocrinol Metab. 25(3-4):383-6, 2012
                                      19. Ming YC et al: Inguinal hernia containing uterus and uterine adnexa in female infants: report of two cases. Pediatr Neonatol. 52(2):103-5, 2011
                                      20. Uyar I et al: Ectopic ovary confirmed by ovarian stimulation in a case of unicornuate uterus. Fertil Steril. 96(2):e122-4, 2011
                                      21. Osifo OD et al: Inguinal hernia in Nigerian female children: beware of ovary and fallopian tube as contents. Hernia. 13(2):149-53, 2009
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Inguinal ovarian hernia, canal of Nuck hernia
                                                • Definitions

                                                  • Ectopic ovary: Abnormally located ovary
                                                    • Inguinal ovarian hernia (95%): Presents as labial mass
                                                    • Intraabdominal ectopia: Incidental or iatrogenic
                                                      • Nonstandard ovarian location is common & usually incidental (due to long ovarian ligaments)
                                                      • Nonpelvic location is sometimes seen after numerous or complex abdominopelvic surgeries
                                                      • Ovarian transposition is sometimes performed to preserve fertility prior to radiation therapy
                                                    • Retroperitoneal location is extremely rare

                                                IMAGING

                                                • General Features

                                                  • Ultrasonographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Rosa F et al: How embryology knowledge can help radiologists in the differential diagnosis of canal of Nuck pathologies. Radiol Med. 126(7):910-24, 2021
                                                                          2. Morabito G et al: A young girl with right ovarian torsion and left ovarian ectopy. Ital J Pediatr. 46(1):51, 2020
                                                                          3. Chan D et al: Canal of Nuck hernias. Acta Radiol Open. 8(12):2058460119889867, 2019
                                                                          4. Jedrzejewski G et al: Nuck canal hernias, typical and unusual ultrasound findings. Ultrasound Q. 35(1):79-81, 2019
                                                                          5. Thomas AK et al: Canal of Nuck abnormalities. J Ultrasound Med. 39(2):385-95, 2019
                                                                          6. Turkgeldi L et al: Laparoscopic ovarian transposition and ovariopexy for fertility preservation in patients treated with pelvic radiotherapy with or without chemotherapy. Facts Views Vis Obgyn. 11(3):235-42, 2019
                                                                          7. Arian SE et al: Ovarian transposition: a surgical option for fertility preservation. Fertil Steril. 107(4):e15, 2017
                                                                          8. Castro AD et al: Ectopic ovary with torsion: uncommon diagnosis made by ultrasound. Radiol Bras. 50(1):60-1, 2017
                                                                          9. Moawad NS et al: Laparoscopic ovarian transposition before pelvic cancer treatment: ovarian function and fertility preservation. J Minim Invasive Gynecol. 24(1):28-35, 2017
                                                                          10. Sameshima YT et al: The challenging sonographic inguinal canal evaluation in neonates and children: an update of differential diagnoses. Pediatr Radiol. 47(4):461-72, 2017
                                                                          11. Karadeniz Cerit K et al: Inguinal hernia containing uterus, fallopian tube, and ovary in a premature newborn. Case Rep Pediatr. 807309, 2015
                                                                          12. Kollia P et al: True ectopic ovary in the right iliac fossa mimicking acute appendicitis and associated with ipsilateral renal agenesis. J Obstet Gynaecol Res. 40(3):858-61, 2014
                                                                          13. Webb JB et al: The management of an ectopic ovary in the inguinal canal: literature review and discussion. Pediatr Surg Int. 30(10):1075-8, 2014
                                                                          14. Yang DM et al: Ultrasonographic diagnosis of ovary-containing hernias of the canal of Nuck. Ultrasonography. 33(3):178-83, 2014
                                                                          15. Aydin R et al: Gray-scale and color Doppler ultrasound imaging findings of an ovarian inguinal hernia and torsion of the herniated ovary: a case report. Pediatr Emerg Care. 29(3):364-5, 2013
                                                                          16. Cascini V et al: Irreducible indirect inguinal hernia containing uterus and bilateral adnexa in a premature female infant: report of an exceptional case and review of the literature. J Pediatr Surg. 48(1):e17-9, 2013
                                                                          17. Irtan S et al: Ovarian transposition in prepubescent and adolescent girls with cancer. Lancet Oncol. 14(13):e601-8, 2013
                                                                          18. Demirel F et al: Inguinal ovary as a rare diagnostic sign of Mayer-Rokitansky-Küster-Hauser syndrome. J Pediatr Endocrinol Metab. 25(3-4):383-6, 2012
                                                                          19. Ming YC et al: Inguinal hernia containing uterus and uterine adnexa in female infants: report of two cases. Pediatr Neonatol. 52(2):103-5, 2011
                                                                          20. Uyar I et al: Ectopic ovary confirmed by ovarian stimulation in a case of unicornuate uterus. Fertil Steril. 96(2):e122-4, 2011
                                                                          21. Osifo OD et al: Inguinal hernia in Nigerian female children: beware of ovary and fallopian tube as contents. Hernia. 13(2):149-53, 2009