Extrapelvic Endometriosis: A Systematic Review.

Primary umbilical endometriosis. Case report and discussion on management options.

Umbilical endometriosis: A radical excision with laparoscopic assistance

Primary umbilical endometriosis is a rare disorder and is defined as the presence of ectopic endometrial tissue within the umbilicus. A patient with painful mass in the umbilicus during menstrual period is studied in this paper. The possibility of subcutaneous endometriosis should be considered when an umbilical mass is detected despite the absence of previous surgery. In this case, urachal cancer, urachal remnant, umbilical endometriosis, and its malignant transformation were among the diseases considered in the differential diagnosis. Complete excision and histology are necessary to obtain a definitive diagnosis and optimal treatment for umbilical subcutaneous endometriosis.

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Primary Umbilical Endometriosis: Unusual and Rare Clinical Presentation.

Primary (spontaneous) umbilical endometriosis is very rare with an estimated incidence of 0.5-1% of all patients with endometrial ectopia. Endometriosis is a common gynecological condition, the pelvis being the most common site of the disease. Extrapelvic site is less common and even more difficult to diagnose due to the extreme variability in presentation. A 38-year-old woman presented with a blackish nodule over the umbilicus of 3 years duration. Fine needle aspiration cytology of the lesion showed cells in clusters and sheets with background of scant stromal fragment, hemosiderin laden macrophages and RBCs, leading to a suggestion of umbilical endometriosis. Histopathological examination of the excised lesion confirmed the same.

Primary umbilical endometriosis - Diagnosis by fine needle aspiration.

Endometriosis is defined as the presence of extra-uterine endometrial tissue. The prevalence rate of umbilical endometriosis ranges from 0.5 to 1.0% of all patients with extragenital endometriosis. In this report, we present a case of primary umbilical endometriosis to highlight the challenges encountered during diagnosis. A nulliparous 39-year-old woman presented to our department with a 2-year history of a tender, painful and non-reducible, firm umbilical mass that enlarged slowly reaching 2 cm in diameter. She had never been pregnant nor had any abdominal surgery. There was no sequential bleeding. Ultrasound of the umbilical region showed a well defined, oval shaped anechoic area. Histological examination on a cutaneous biopsy concluded umbilical endometriosis. The patient was subsequently referred to a gynecologist and underwent surgery with en bloc excision of the lesion. Generally, umbilical endometriosis presents as a roundish tumuor that can either partly or completely occupy the umbilical scar with intermittent bleeding. Characteristically, the mass increases with the menstrual cycle, becoming more evident and usually harder and is associated with cyclic pain. Its pathogenesis remains uncertain. Clinical diagnosis is difficult, and umbilical endometriosis can be easily confused with other conditions such as benign and malignant tumours. Ultrasound examination is useful, and surgical excision is the treatment of choice. Several cases of malignant transformation have also been described.

Primary umbilical endometriosis: a rare variant of extragenital endometriosis.

Background Anorectal melanoma is a rare and aggressive mucosal cancer. There is usually a delay in diagnosis because about 30% of these cancers are amelanotic and are often mistaken for benign conditions. Herein, we report a case of amelanotic anorectal malignant melanoma with an unusual metastatic deposit in the vulva and also review the literature. Case report A 67-year-old woman presented with a history of prolapse of an anal tumour. Clinical examination showed a pedunculated and ulcerated amelanotic tumour associated with three other nodules, 1 cm in diameter, localized in the vulval mucosa. A left inguinal node was palpable. Histological examination and immunohistochemical staining of all tumours demonstrated malignant melanoma. Radiological diagnostic procedures revealed no evidence of metastases. Discussion Nine cases of amelanotic malignant melanoma have been reported in the literature. The age at diagnosis ranged from 45 to 77 years. Females appear to be far more frequently involved than males (F/M = 7/2). Anorectal melanoma is most common in the rectum, followed by the anal canal. Metastases occur early. Our case is the tenth case of amelanotic anorectal melanoma and probably corresponds to multiple synchronous primary melanomas of the anorectal region and the vulva, with the possibility that one of the lesions is a primary melanoma and the others are satellite lesions. Wide local excision where negative margins can be achieved is the preferred treatment.

Primary amelanotic anorectal melanoma: an uncommon neoplasia with poor prognosis.

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Primary umbilical endometriosis: a rare variant of extragenital endometriosis.

Primary amelanotic anorectal melanoma: an uncommon neoplasia with poor prognosis.