Mba S G, Omeke C A, Enebe J T, Anyanwu O C
Department of Obstetrics & Gynaeoclogy, Enugu State University of Science and Technology, College of Medicine/Teaching Hospital, Parklane, Enugu, Nigeria.
Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology Teaching Hospital, Parklane, Enugu, Nigeria.
Int J Surg Case Rep. 2022 May;94:107129. doi: 10.1016/j.ijscr.2022.107129. Epub 2022 Apr 29.
Uterine fibroids and endometriosis are independent causes of infertility/subfertility in women of reproductive age. Primary umbilical endometriosis is rare.
Here, we report a case of primary umbilical endometriosis coexisting with multiple uterine fibroids in a 35 year old nulliparous woman who presented with abdominal swelling as well as cyclical pain and swelling of the umbilicus without any previous surgery. She had abdominal myomectomy and excision of the umbilical lesion with histological confirmation of uterine fibroids and umbilical and peri-umbilical endometriosis.
Primary umbilical endometriosis should be considered as a possible differential diagnosis in cases of umbilical disorders even if the patient has no typical symptoms of pelvic endometriosis. The clinical features include an umbilical swelling (90%), often associated with cyclical pain (81.5%) and bleeding or discharge (49.2%); while some patients may be asymptomatic. The diagnosis of umbilical endometriosis could be made based on clinical findings but histological confirmation is the gold standard for diagnosis. The definitive treatment for umbilical endometriosis is surgical excision.
Although rare, primary umbilical endometriosis may coexist with uterine fibroids and should be suspected in women of reproductive age who complain of cyclical umbilical disorders in addition to abdominal swelling or other symptoms of uterine fibroids.
子宫肌瘤和子宫内膜异位症是育龄期女性不孕/亚生育的独立原因。原发性脐部子宫内膜异位症较为罕见。
在此，我们报告一例35岁未生育女性，其原发性脐部子宫内膜异位症与多发性子宫肌瘤并存。该患者表现为腹部肿胀以及脐部周期性疼痛和肿胀，既往无任何手术史。她接受了腹部肌瘤切除术及脐部病变切除术，组织学证实为子宫肌瘤以及脐部和脐周子宫内膜异位症。
即使患者没有盆腔子宫内膜异位症的典型症状，原发性脐部子宫内膜异位症也应被视为脐部疾病可能的鉴别诊断。临床特征包括脐部肿胀（90%），常伴有周期性疼痛（81.5%）以及出血或分泌物（49.2%）；而一些患者可能无症状。脐部子宫内膜异位症的诊断可基于临床发现，但组织学确诊是诊断的金标准。脐部子宫内膜异位症的 definitive 治疗是手术切除。
尽管罕见，原发性脐部子宫内膜异位症可能与子宫肌瘤并存，对于除腹部肿胀或其他子宫肌瘤症状外还主诉周期性脐部疾病的育龄期女性应怀疑此病。
