Cyclically bleeding trocar-site endometrioma without known history of endometriosis: case report and literature review.

Naveed A. Rahman, Timothy Shope
Journal of surgical case reports · 2022 · vol. 2022(11) , pp. rjac498 · doi:10.1093/jscr/rjac498 · PMID:36389442 · PMC9659428 · W4309413437
article OA: gold CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a 43-year-old woman with cyclical umbilical bleeding from a mass, confirmed as endometriosis at a laparoscopic trocar site, despite no prior endometriosis diagnosis and a unique surgical history.

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Abstract

Endometriosis occurrence at a laparoscopic trocar-site incision is extremely rare with only 30 previous cases published. We present a 43-year-old female with surgical history of two cesarean sections and a laparoscopic Roux-en-Y gastric bypass who presented with history of cyclical bleeding from an umbilical mass coinciding with her menstrual cycle. Ultrasound demonstrated a complex solid and cystic lesion measuring 2.5 x 1.4 x 1.4 cm. This umbilical mass was surgically resected and gross examination perioperatively demonstrated dark-colored cystic implants consistent with endometrioma. Pathology confirmed the suspected diagnosis of endometriosis. There are several noteworthy characteristics in this unique case of laparoscopic trocar-site endometrioma. Umbilical bleeding is an unusual presenting symptom that has not been previously reported. This endometrioma occurred at the umbilical laparoscopic site rather than her Pfannenstiel incision. Laparoscopic Roux-en-Y gastric bypass has not been previously associated with trocar-site endometrioma. Of note, this patient had no known history of endometriosis.

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endometriosisendometrioma

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