Raj Felix Anand, Padmakumar Divya, Selvam Pavithra, Ajmal Imran Thariq
Department of General Surgery, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, IND.
Cureus. 2024 Jul 26;16(7):e65473. doi: 10.7759/cureus.65473. eCollection 2024 Jul.
Primary extrapelvic endometriosis is the presence of endometrial tissue in sites outside the uterine cavity in an individual who has had no prior abdominal surgeries. Various theories have been postulated to describe the etiology of endometriosis. Our case study involves a multiparous patient in her late 40s with no prior abdominal surgeries who presented with bleeding from her umbilicus associated with swelling and pain corresponding to her menstrual cycle. A computed tomography scan of the abdomen detected a homogenous granuloma-like umbilical soft tissue mass. The umbilical nodule and the umbilicus were excised, and the specimen was sent for histopathological examination that validated the diagnosis of an umbilical endometrioma by revealing endometrial glands with stroma involving the dermis. Postoperatively, the patient was symptomatically better and was discharged. Primary umbilical endometriosis can mimic conditions like omphalitis, umbilical granuloma, and umbilical hernia; hence, it is important to understand how to differentiate this case from other diagnoses. This case contextualizes that the likelihood of primary umbilical endometriosis in such unusual presentations must always be considered.
原发性盆腔外子宫内膜异位症是指在未进行过腹部手术的个体中，子宫腔外部位存在子宫内膜组织。关于子宫内膜异位症的病因，人们提出了各种理论。我们的病例研究涉及一名40多岁的经产妇，她之前没有做过腹部手术，出现了脐部出血，并伴有与月经周期相应的肿胀和疼痛。腹部计算机断层扫描发现脐部有一个均匀的肉芽肿样软组织肿块。切除了脐部结节和脐部，将标本送去进行组织病理学检查，通过发现含有累及真皮的间质的子宫内膜腺体，证实了脐部子宫内膜瘤的诊断。术后，患者症状改善并出院。原发性脐部子宫内膜异位症可类似脐炎、脐肉芽肿和脐疝等病症；因此，了解如何将该病例与其他诊断区分开来很重要。该病例表明，对于这种不寻常表现的原发性脐部子宫内膜异位症，必须始终考虑其可能性。
