Umbilical endometriosis in a 42 years old parous woman: A Case Report

Mosammat Nargis Shamima, Mohd Alamgir Hossain, Shahela Jesmin, Nargis Jahan, Arpita Das
In: TAJ: Journal of Teachers Association · 2018 · vol. 28(1) , pp. 48–51 · doi:10.3329/taj.v28i1.39070 · W2903531250
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This case report describes a 42-year-old parous woman with umbilical endometriosis, diagnosed via ultrasonography and FNA cytology, who was successfully treated with surgical excision.

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This paper is a case report of a 42-year-old multigravid woman with a 6-year history of painful umbilical swelling and cyclical bleeding from the umbilicus during menstruation, without prior reported endometriosis, dysmenorrhea, or dyspareunia. The authors used clinical examination along with high-resolution ultrasonography and fine needle aspiration cytology to arrive at an accurate preoperative diagnosis of umbilical (extra-pelvic) endometriosis; they note that differential diagnosis can be difficult and suggest epiluminescence and MRI for diagnostic accuracy. Surgical excision of the lesion with adequate umbilical repositioning was performed, and the patient was asymptomatic with minimal visible scarring at 12-month follow-up. This paper is centrally about endometriosis — it reports a case of umbilical endometriosis presenting as a “menstruating tumor.”

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Abstract

Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Rajshahi. The patient was 42 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 6 years with cyclical bleeding from the umbilical region for same duration. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. Clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery). A natural-looking umbilicus was observed with minimal visible scars.TAJ 2015; 28(1): 48-51
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Umbilical endometriosis in a 42 years old parous woman: A Case Report DOI: https://doi.org/10.3329/taj.v28i1.39070Keywords: Endometriosis, umbilicus, extra pelvic endometriosis, menstruating tumorAbstract Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Rajshahi. The patient was 42 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 6 years with cyclical bleeding from the umbilical region for same duration. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. Clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery). A natural-looking umbilicus was observed with minimal visible scars. TAJ 2015; 28(1): 48-51 Downloads 204 169

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endometriosisdysmenorrheadyspareunia

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