Primary umbilical endometriosis - Diagnosis by fine needle aspiration

Abstract

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.

Concurrent Spontaneous Umbilical and Abdominal Wall Endometriosis Retracting the Surrounding Cutis

“…The differential diagnosis should include lipoma, dermoid cyst, haemangioma, keloid, hernia, abscess, pyogenic or foreign granuloma, embryological rests, irreducible hernia, inclusion cyst, metastatic tumors from intraabdominal malignancy and melanoma (Din, 2013;Kyamidis, 2011;Singh, 2012). Fine needle aspiration cytology may be conducted (Fernandes, 2011) even if histology is the best diagnostic tool, supported by immunohistochemical analysis of estrogen and progesterone receptors when the excessive fibrosis hides field (Kyamidis, 2011).The complete excision of the lesion, under local or loco-regional anesthesia, is the treatment of choice and usually curative. Hormonal therapies are insufficient as sole treatments (Kyamidis, 2011).…”

A Curious Case of Recurrent Umbilical Swelling: Case Report and Literature Review

“…A characteristic sign for this lesion is the simultaneous sanguinolent discharges with menstruation. Clinical symptoms typically include pain, bleeding, and swelling concurrently with menstruation, however others are asymptomatic [9] [10]. The presence of a previous history of endometriosis is common (26% of cases) [11], frequently associated with complaints of dysmenorrhoea, dyspareunia, or defecation pain [2].…”

Spontaneous Cutaneous Endometriosis of the Umbilicus: A Case Report

“…The precise pathogenesis of spontaneous cutaneous endometriosis however, remains an enigma. Overall, umbilical endometriosis is relatively uncommon and represents only 0.5-1% of all cases of ectopic endometrial tissue [8,9,11]. We present an unusual case of spontaneous (primary) cutaneous endometriosis with cilia in the umbilicus of a nulliparous woman with no history of surgical intervention.…”