Umbilical endometriosis along with peritoneal endometriosis: a case report

Incidence of endometriosis is around 10 to 15% in women of reproductive age group. Umbilical endometriosis is a very rare entity. Extra genital endometriosis accounts to 3% of endometriosis. Incidence of umbilical endometriosis is 0.5%-4% of extra genital endometriosis. 30 years old multi gravida was referred to our hospital with c/o periodic bleeding from the umbilicus for the past 3 months. She was also having dysmenorrhoea for about 3 months. On examination, patient had a small bluish nodule in the umbilicus around 1.5x1.2 cm in size. Clinically there was suspicion of pelvic endometriosis as the uterus was retroverted and fixed. CT abdomen showed a small hypo-echoeic area in the umbilicus and uterus was adenomyotic with normal ovaries. Patient was given the option of laparoscopy and excision of umbilicus, as there was suspicion of peritoneal endometriosis and the patient also insisted upon laparoscopic sterilization. Laparoscopy showed early peritoneal endometriosis with pelvic adhesions and the same adhesiolysis was done along with cauterization of endometriosis. Sterilization was also done as per the patient’s request. Umbilical excision and layer closure was done. Umbilical endometriosis is a rare entity. This patient had associated early pelvic endometriosis. Umbilical endometriosis could be secondary to the lympho vascular spread from the pelvic endometriosis or primary umbilical endometriosis. History, clinical and imaging were pointing towards umbilical endometriosis. Surgical excision of umbilical endometriosis and cauterisation of early pelvic endometriosis were done. Patient needs follow up. Umbilical endometriosis may be primary or secondary which needs total excision and follow up.

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Scar endometriosis-rare and painful entity: a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211551 ◽

2021 ◽

Vol 10 (5) ◽

pp. 2104

Author(s):

Anita Yadav ◽

Jyoti Baghel ◽

Rajneesh Rawat ◽

Avinash Prakash

Keyword(s):

Rare Case ◽

Rectus Sheath ◽

Surgical Excision ◽

Tertiary Level ◽

Rare Entity ◽

Pelvic Endometriosis ◽

Rare Type ◽

Detailed History ◽

Scar Endometriosis

Scar endometriosis is a rare type of extra-pelvic endometriosis that develops following obstetrical and gynecological surgeries. It is a rare entity, though probably on the rise, due to the increase in caesarean sections performed worldwide. This manuscript reports a rare case of scar endometriosis involving rectus sheath following repeat caesarean section and was managed at a tertiary level centre. The patient required surgical excision of the lesion and was kept on regular follow-up following surgery. The physiopathology of scar endometriosis is complex; its symptomatology is rich and diverse but detailed history, thorough clinical examination along with imaging and histopathological evaluation is usually efficient in diagnosing the condition.

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Vulval aggressive angiomyxoma – a rare entity

MOJ Clinical & Medical Case Reports ◽

10.15406/mojcr.2021.11.00391 ◽

2021 ◽

Vol 11 (4) ◽

pp. 100-102

Author(s):

Jayakar Thomas

Keyword(s):

Surgical Excision ◽

Reproductive Age ◽

Soft Tissue Tumour ◽

Aggressive Angiomyxoma ◽

Age Group ◽

Rare Entity ◽

Women Of Reproductive Age ◽

Tissue Tumour ◽

The Right ◽

Reproductive Age Group

Aggressive Angiomyxoma is a very rare, distinctive, locally invasive soft tissue tumour, that occurs most commonly in the perineum, pelvis, vulva and vagina. It is seen mostly in women of reproductive age group. It has a tendency for recurrence locally, treatment being surgical excision. We hereby describe a case of 38-year-old patient with a pedunculated growth on the right labium majora.

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PRIMARY UMBILICAL ENDOMETROSIS

Caliphate Medical Journal ◽

10.47837/cmj.19770126.201531169 ◽

2015 ◽

Vol 3 (1) ◽

pp. 249-251

Author(s):

Panti AA ◽

Tunau KA ◽

Agbo SP ◽

Mohammed U ◽

Omokanye lO ◽

...

Keyword(s):

Differential Diagnosis ◽

Histopathological Examination ◽

Reproductive Age ◽

Age Group ◽

Rare Entity ◽

Women Of Reproductive Age ◽

Endometrial Cavity ◽

History Of ◽

Reproductive Age Group ◽

Umbilical Endometriosis

Background: Primary endometriosis is the presence of endometrial glands and tissues outside the endometrial cavity. Primary umbilical endometriosis is a very rare entity. Case:We reported a 40-year-old Para 2 plus 2Alive 2 patient who presented with 2 year history of umbilical swelling with cyclical pain. The case was managed by simple excision and histopathological examination diagnosed it as a case of umbilical endometriosis. Conclusion: Endometriosis should be considered as a differential diagnosis in cases of any umbilical pain or swelling in women of reproductive age group.

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Multiple Koenen Tumors, a Rare Entity: Combination Treatment with 1% Topical Sirolimus Electrofulguration and Excision

Skin Appendage Disorders ◽

10.1159/000511743 ◽

2020 ◽

Vol 7 (1) ◽

pp. 66-70

Author(s):

Vishalakshi Viswanath ◽

Jay D. Gupte ◽

Niharika Prabhu ◽

Nilima L. Gour

Keyword(s):

Tuberous Sclerosis ◽

Combination Treatment ◽

Tumor Regression ◽

Surgical Excision ◽

Tumor Formation ◽

Rare Entity ◽

Rare Presentation ◽

Cutaneous Manifestations ◽

Elderly Female

Introduction: Koenen tumors are benign, cutaneous manifestations of tuberous sclerosis. These are disfiguring, painful, and challenging to treat as they frequently recur. We report a case of long-standing, multiple Koenen tumors affecting all twenty nails in an elderly female who was successfully treated with a combination of topical sirolimus 1%, surgical excision, and electrofulguration. Case Report: A 57-year-old lady presented with multiple, asymptomatic periungual, and subungual tumors affecting all twenty nails since 27 years. Cutaneous examination revealed confetti macules, ash-leaf macule, and shagreen patch over trunk. Nail biopsy was compatible with Koenen’s tumor. Computerized tomography of brain showed diffuse patchy sclerosis. The tumors were treated with topical sirolimus 1% ointment for 10 months with excellent regression. Electrofulguration for both great toenails and surgical excision of right thumbnail periungual fibroma was done. 1% sirolimus was advised after the surgical treatment. There were no adverse effects or recurrence of tumors over a 2-year follow-up. Discussion: Topical sirolimus 1% was effective in tumor regression and preventing new tumor formation. Larger tumors that interfered in daily chores were treated with excision and electrofulguration. Thus, a combination treatment for this rare presentation of tuberous sclerosis provided optimum results.

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Giant Synovial Cyst of Thigh: A Rare Entity

Case Reports in Orthopedics ◽

10.1155/2013/967215 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Kushagra Sinha ◽

Rajesh Maheshwari ◽

Atul Agrawal

Keyword(s):

Knee Joint ◽

Surgical Excision ◽

Inflammatory Cells ◽

Synovial Cyst ◽

Rare Entity ◽

The Past ◽

Inflammatory Conditions ◽

Precise Diagnosis ◽

Synovial Cysts ◽

Laboratory Investigations

Synovial cyst occurs secondary to traumatic, degenerative, or inflammatory conditions. Synovial cysts represent abnormal distension of bursae, which communicate with the joint. Giant synovial cysts are typically due to rheumatoid arthritis, other causes being trauma and synovial pseudoarthrosis. A 33-year-old male presented to an outpatient clinic with a massive swelling on his posterolateral aspect of right thigh extending from upper one-third to the knee joint which had been increasing in size over the past six months. This was associated with dull aching pain. All laboratory investigations were within normal parameters. Even FNAC was inconclusive. With time, swelling was increasing in size. Ultrasound revealed the cystic nature of swelling. MRI showed large cystic lesion 24 × 10 × 12 cm in posterolateral aspect of thigh extending up to knee joint. Following the MRI, an excision was planned. After excision, histological examination confirmed the synovial nature of the cyst, which had a collagenous wall and dense chronic inflammatory cells. As the disease is extremely rare and asymptomatic, precise diagnosis is difficult and often delayed. We consider that open surgical excision should be reserved for cases of large synovial cysts because it can provide a complete resection of the lesion and minimize the risk of recurrence.

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Appendicular endometriosis: a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210347 ◽

2021 ◽

Vol 10 (2) ◽

pp. 794

Author(s):

Priyanka Bagdi ◽

Niranjani S.

Keyword(s):

Case Report ◽

Uterine Cavity ◽

Reproductive Age ◽

Complete Suppression ◽

Pelvic Endometriosis ◽

Recurrent Pain ◽

Abdominal Symptoms ◽

History Of ◽

Pain History ◽

Reproductive Age Group

Endometriosis is an estrogen-dependent inflammatory disease that affects 8 to 10% of women at reproductive age, characterized by the presence of endometrial glands and stroma outside the uterine cavity. In our case we are presenting a case report of a reproductive age group woman with appendicular endometriosis, because of the presence of pelvic endometriosis combined with an enlarged appendix, the choice was appendectomy, with complete suppression of abdominal symptoms after the surgery, a fact also reported by other authors. We concluded that endometriosis of the appendix is rare and almost never diagnosed before the surgery, with the definitive diagnosis obtained through microscopic examination. However, it should always be taken into account for the diagnosis of chronic pelvic pain, especially in young women complaining of recurrent pain, history of infertility and pelvic endometriosis.

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A clinical study on ectopic pregnancy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174671 ◽

2017 ◽

Vol 5 (11) ◽

pp. 4776

Author(s):

Mamata Soren ◽

Ranjita Patnaik ◽

Bismoy Kumar Sarangi

Keyword(s):

Ectopic Pregnancy ◽

Reproductive Age ◽

Medical Emergency ◽

Diagnostic Tools ◽

Age Group ◽

Lower Abdomen ◽

The Past ◽

Surgical Emergencies ◽

Β Hcg ◽

Reproductive Age Group

Background: Ruptured ectopic pregnancy is a medical emergency; therefore, it is imperative to diagnose the unruptured ectopic pregnancy such that timely intervention will prevent morbidity and mortality Today with availability of monoclonal β-HCG, high resolution transvaginal scan and laparoscopy it is possible to make early diagnosis even before rupture.Methods: Prospective study of two years duration with sample of 72 cases of suspected ectopic pregnancy observed and treated out of total 20193 pregnant women admitted were included in this study.Results: The incidence was 0.36%, maximum between the age group of 26-30 years (33.3%). Risk factors were tubectomy (30.56%), D and C (6.94%), PID (5.6%), previous ectopic (1.39%), IUCD (2.78%). The typical triad of amenorrhoea, pain abdomen and bleeding was observed in 54.2% of cases. 19 patients were brought in shock (26.4%). Ultrasonography done in 56 cases.Conclusions: There is an increase in the incidence of ectopic pregnancy but a decrease in maternal mortality during the past two decades. Although the early diagnostic tools were available, we had to manage most of our patients as surgical emergencies, as they were brought late in the trial, with established diagnosis of ruptured ectopic pregnancy. Physicians should be sensitive to the fact that in the reproductive age group any women presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be entertained irrespective of the presence or absence of amenorrhoea, whether or not she has undergone sterilization.

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Primary Umbilical Endometriosis: Report of a Rare Case

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v13i1.19426 ◽

2014 ◽

Vol 13 (1) ◽

pp. 67-69

Author(s):

Dilip K. Bhowmik ◽

Rezwana Mirza ◽

Amzad Hossain

Keyword(s):

Rare Case ◽

The Body ◽

Reproductive Age ◽

Age Group ◽

Pelvic Organs ◽

Almost All ◽

Reproductive Age Group ◽

Umbilical Endometriosis

Endometriosis is the commonest gynaecological problem; it affects 7 to 10% women in reproductive age group. Commonest site being the pelvic organs, extrapelvic presentation in almost all parts of the body have been reported. However umbilical endometriosis has been reported in more than one hundred cases. It was first described by Villar in 1886. Umbilical endometriosis accounts for only 0.5% to 1% of all endometriosis cases. Most of the reported cases occurred in the scar following gynaecological and obstetrical surgery. A few cases of primary umbilical endometriosis have been reported. We report such a rare case of primary umbilical endometriosis and the diagnosis was done by FNAC & the patient underwent wide local excision.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19426

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Assessment of Gonadal Function Following Single Dose of Radioiodine Therapy in Differentiated Thyroid Cancer Patients of Reproductive Age

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v19i2.35862 ◽

2018 ◽

Vol 19 (2) ◽

pp. 92

Author(s):

Md Sunny Anam Chowdhury ◽

Sadia Sultana ◽

Md Abdul Awal ◽

Suraya Sarmin ◽

Mohammad Simoon Salekin

Keyword(s):

Thyroid Cancer ◽

Single Dose ◽

Differentiated Thyroid Cancer ◽

Reproductive Age ◽

Age Group ◽

Gonadal Function ◽

Male Patients ◽

The Mean ◽

Reproductive Age Group

Objective: This interventional study has undertaken to assess the gonadal function of differentiated thyroid cancer (DTC) patients within reproductive age group following single dose of radioactive iodine (131I) therapy/ablation.Patients and Methods: A total of 69 patients (25 male and 44 female) of DTC were included in this study, those were referred for 131I ablation after total thyroidectomy. Following RAI, these patients were followed-up three times at three months interval. The usual I-131 dose was 75 or 100 m Ci for ablation of thyroid residues and 150 mCi for treatment of nodal metastasis. All the patients were interviewed about menstrual (female only) and reproductive history and investigated of the level of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone of male patients and FSH, LH, estradiol (E2) of female patients before administration of 131I and three, six and nine months after therapy.Result: In this study all of the 25 (100.0%) male patients showed high FSH level after three months of therapy. The mean± SD FSH level of male patients was found significantly (p-0.001) higher (15.59±7.53 IU/L) after three months of therapy than the pretherapy (4.85±2.57 IU/L) level. The mean± SD of FSH level was significantly declining in six months and nine months of follow up. The mean± SD of LH hormone level of these patients was found 6.1±3.67 IU/L in pretherapy which was significantly increased to 7.67±4.33 IU/L after three months. The mean LH level was 7.20±3.98 IU/L at six months follow up and 7.3±3.5IU/L after nine months. The differences of LH level between 3 months to 6 months and 6 months to 9 months are not statistically significant. No significant change was observed in testosterone level throughout the study period. In female, five patients developed irregular menstruation (changed duration of cycle or lighter amount), three patients developed amenorrhea associated with hot flashes within six months of 131I administration. Biochemical study of the patients with amenorrhoea showed markedly elevated serum FSH, LH level and declined E2 level. The FSH, LH levels of the two patients with amenorrhea became normal within study period and one patient had persistent amenorrhea at 9 months. E2 level raised slowly.Conclusion: A single dose of radio-iodine (131I) therapy causes impairment of gonadal function of male patients within reproductive age group. In case of female patients the effect is insignificant. The effect is usually reversible and gonadal function of the patients restores within the study period.Bangladesh J. Nuclear Med. 19(2): 92-97, July 2016

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Caesarean scar endometriosis: a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180922 ◽

2018 ◽

Vol 7 (3) ◽

pp. 1221

Author(s):

Fatimazahra Cherrabi ◽

Mounir Moukit ◽

Jaouad Kouach ◽

Driss Moussaoui Rahali ◽

Mohammed Dehayni

Keyword(s):

Case Report ◽

Preoperative Diagnosis ◽

Surgical Excision ◽

Reproductive Age ◽

Rare Entity ◽

Radiological Imaging ◽

Women Of Reproductive Age ◽

Scar Endometriosis ◽

Caesarean Scar ◽

Appropriate Treatment

Endometriosis is a common disorder in women of reproductive age but is rarely observed in abdominal scar after caesarean section. The authors report a case of 35-year-old woman referred for a painful lump at caesarean scar. Preoperative diagnosis of caesarean scar endometriosis was made on the basis of clinical examination and radiological imaging and confirmed histologically after large surgical excision of the mass. Increasing awareness of this rare entity among clinicians can help in early diagnosis and appropriate treatment.

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