Umbilical epidermal inclusion cysts, an unusual cause of umbilical mass following laparoscopic surgery: case report

Abstract

Umbilical lumps are a common presentation that can represent a diagnostic challenge as the differentials are broad. Epidermal inclusion cysts occur when epidermal cells are implanted in the dermis following trauma, or surgery. Although epidermal inclusion cysts are common, they are rarely cause of umbilical mass, with less than 10 cases described in the literature. Very few cases have been reported following abdominal surgery and none following laparoscopy. These lesions can occur with or without pain, mass, redness or spontaneous discharge and symptoms can persist for years. This paper reports a case of an umbilical epidermal inclusion cyst in a 52-year-old female presenting with a 6-week history of a painful, red umbilical lump on a background of two previous diagnostic laparoscopies. This was successfully treated with complete excision of the lesion.

Umbilical Complications That Require Surgical Intervention after Gynecologic Laparoscopic Surgery

“… 7 Also to be taken into consideration as a differential diagnosis are an umbilical hernia, embryologic remnant abnormalities, metastatic tumors, ectopic endometriosis, suture granulomas, and epidermal cysts, although the development of an umbilical mass following laparoscopic surgery is extremely rare. 8 , 9 Local infection, ectopic endometriosis, scar contracture, and tissue necrosis were the most frequent causes of surgery needed for an umbilical complication after laparoscopic surgery in our department (79%), which is consistent with prior data. One case not included in this report but scheduled for surgery in the future in our department includes an umbilical hernia.…”

A cutaneous lesion mimicking pacemaker infection

“…As far as we know, EIC mimicking a pacemaker‐related infection has not been reported previously. EIC is an extremely rare condition that occurs secondary to implantation and proliferation of epidermal cells into the dermis and subcutaneous tissue because of injury such as surgery, puncture and trauma 4,5 . EIC has been reported after anesthetic infiltration, lumbar puncture, laparoscopic or abdominal surgery, and percutaneous procedures 4,5 .…”

“…EIC is an extremely rare condition that occurs secondary to implantation and proliferation of epidermal cells into the dermis and subcutaneous tissue because of injury such as surgery, puncture and trauma. 4 , 5 EIC has been reported after anesthetic infiltration, lumbar puncture, laparoscopic or abdominal surgery, and percutaneous procedures. 4 , 5 In our case, the trauma produced by puncture due to local anesthetic infiltration or during Seldinger technique for lead implantation can be the etiology of this particular EIC that can occur several years after surgery.…”

“… 4 , 5 EIC has been reported after anesthetic infiltration, lumbar puncture, laparoscopic or abdominal surgery, and percutaneous procedures. 4 , 5 In our case, the trauma produced by puncture due to local anesthetic infiltration or during Seldinger technique for lead implantation can be the etiology of this particular EIC that can occur several years after surgery. The puncture could remove epidermal cells from epidermis or cells located inside the pocket during pocket creation to deeper tissues.…”