Primary umbilical endometriosis – A rare presentation of cutaneous endometriosis

Primary umbilical endometriosis is a rare condition with an overall incidence of around 0.5% to 1% among all the endometriosis cases, but at times it poses a diagnostic dilemma. In our institution we encountered a case of primary umbilical endometriosis presented to multiple surgical speciality departments. A prompt clinical examination with surgical biopsy was the key tool which lead to the diagnosis and providing a complete cure for the patient. Pelvic endometriosis affects 5-10% of women in the child bearing age group. The most pronounced symptoms are dyspareunia, pelvic pain, and infertility. Clinical presentations of umbilical endometriosis are as a nodule with or without associated umbilical pain and bleeding. This patient was given primary hormonal therapy and later underwent a biopsy which paved way for an accurate diagnosis of primary umbilical endometriosis. In this case of umbilical swelling, conditions like a benign nevus, lipoma, abscess, cyst, hernia, as well as metastatic deposit from a systemic malignancy were considered in the clinical differential diagnosis. However surgical excision helped us arrive at a definitive diagnosis and cure for the patient.

Painless umbilical nodule in a nulliparous female – A clinical quandary

Background: Endometriosis is a well-known entity most often found within the pelvis and extra pelvic sites like skin, diaphragm, gastrointestinal tract and brain. Primary umbilical endometriosis is a rare form of cutaneous endometriosis, typically presenting as a hyperpigmented umbilical nodule with or without cyclical pain. We present a case of painless umbilical nodule with discolouration in a nulliparous woman, unsuspected clinically with the diagnosis being made primarily on cytology. Case report: A forty-year old female presented with a painless, brownish discoloured umbilical nodule, which was present since two months, was irreducible and had a negative cough impulse. She had no prior surgeries. Ultrasonography of abdomen and pelvis revealed a hypodense lesion of 2cm in the umbilicus, suggesting a possibility of umbilical granuloma. Uterus showed leiomyomata. Cytological evaluation of the umbilical nodule was suggestive of endometriosis. The patient underwent hysterectomy for leiomyomata and omphalectomy. Histopathology confirmed the diagnosis of umbilical endometriosis supported by the immunohistochemistry marker (CD10) being positive for endometrial stromal cells. The uterus had adenomyotic foci in addition to leiomyomata. Conclusion: The clinical distinction between primary umbilical endometriosis and other causes of umbilical nodules is challenging. Imaging modalities do not show pathognomonic signs in establishing this diagnosis. A definitive diagnosis is possible on cytology based on classical morphological features with histopathological examination being the gold standard diagnostic modality.

Umbilical endometriosis: a case report and review of the literature

Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. It affects 7-10% of women of reproductive age. Most commonly, the condition affects pelvic organs, however, 12% are encountered at extragenital sites, such as lungs, diaphragm, or umbilicus. Authors present the case of a 32 year old patient presenting with secondary umbilical endometriosis, after a recent surgical procedure. Manifesting umbilical mass, pain and catamenial bleeding from the umbilicus.

Umbilical Reconstruction with Double Opposing Semilunar Flap, an Appealing Results

Umbilical loss is not a common problem encountered in plastic surgery routine cases. The absence of umbilicus will cause significant effect in total aesthetic appearance of the abdomen, thus making it an essential part of anatomy landmark. Congenital defect, oncologic and abdominoplasty complication are the most often causes, and tremendous psychological trauma will cause patient to seek help. There are many proposed technique for such reconstruction, based on original scar or wound and final expected shape, of course with their advantages and disadvantages. We used a double opposing semilunar flap for our cases. Along with its technical detail, we will present three cases comprises of the defect after omphalocele scar removal, umbilical endometriosis excision and postcentral abdominal tumor excision. Reports will be presented with preoperative dan postoperative result.