Primary Cutaneous Endometriosis of Umbilicus

Cutaneous endometriosis is defined by the presence of endometrial glands and/or stroma in skin and represents less than 1% of all ectopic endometrium. Cutaneous endometriosis is classified as primary and secondary. Primary cutaneous endometriosis appears without a prior surgical history and secondary cutaneous endometriosis mostly occurs at surgical scar tissue after abdominal operations. The most widely accepted pathogenesis of secondary endometriosis is the iatrogenic implantation of endometrial cells after surgery, such as laparoscopic procedures. However, the pathogenesis of primary endometriosis is still unknown. Umbilical endometriosis is composed only 0.4% to 4.0% of all endometriosis, however, umbilicus is the most common site of primary cutaneous endometriosis. A 38-year-old women presented with solitary 2.5×2.0-cm-sized purple to brown colored painful nodule on the umbilicus since 2 years ago. The patient had no history of surgical procedures. The skin lesion became swollen with spontaneous bleeding during menstruation. The skin lesion was diagnosed as a keloid at private hospital and has been treated with lesional injection of steroid for several times but there was no improvement. Imaging studies showed an enhancing umbilical mass without connection to internal organs. Biopsy specimen showed the several dilated glandular structures in dermis. They were surrounded by endometrial-type stroma and perivascular infiltration of lymphocytes. The patient was diagnosed as primary cutaneous endometriosis and skin lesion was removed by complete wide excision without recurrence. We report an interesting and rare case of primary umbilical endometriosis mistaken for a keloid and review the literatures.

A Case of Cutaneous Endometriosis Combined with Epidermal Cyst in the Cesarean Section Scar / 대한피부과학회지

Endometriosis is the abnormal growth of endometrial glands and stroma outside the uterine cavity. Cutaneous endometriosis is a very rare form of extrapelvic endometriosis, and this most commonly occurs at the site of a previous abdominal or pelvic procedure such as hysterectomy, laparoscopy, episiotomy and cesarean section. The classic symptom is a painful nodule that becomes bigger and tenderer during menstruation. Because cutaneous endometriosis is unfamiliar to dermatologists, it can be easily misdiagnosed as other skin tumors. We present here a case of cutaneous endometriosis combined with epidermal cyst, and this developed in the cesarean section scar of a 28-year-old woman.

Cutaneous Endometriosis after Abdominal Myomectomy

Endometriosis is the aberrant presence of endometrial tissue outside the uterine cavity. We report a case of cutaneous endometriosis which developed on the scar of a uterine myomectomy in a 35-year-old female. The patient presented with a bean-sized, oval-shaped, erythematous nodule, which was located where a drain tube had been inserted. During her first visit to our clinic, she felt slight pain upon light touch to the lesion. She was not menstruating at this time. The lesion had been getting bigger and she reported that the pain was aggravated during menstruation. Diagnosis was confirmed by histopathologic examination, which showed multiple endometrial glands with decidualized stroma, and hemosiderin pigment. Many dermatologists are not familiar with cutaneous endometriosis. Therefore, we present this case as a good example which shows pathognomonic symptoms and characteristic histopathologic findings of cutaneous endometriosis.

A Case of Primary Cutaneous Endometriosis at the Unbilicus / 대한산부인과학회지

Cutaneous endometriosis seems to be more common in women who have had a pelvic or abdominal operation and primary cutaneous endometriosis is very rare. In our hospital we experienced a 41-year-old woman who complained of the appearance at the umbilicus of a nodule and had not had operation. This nodule was responsible for recurrent pain and increasing in size and it was excised. Pathology findings revealed cutaneous endometriosis. So we present a case of primary cutaneous endometriosis with a brief review of literature.

A Case of Cutaneous Endometriosis in the Episiotomy Scar / 대한피부과학회지

Endometriosis is defined as the abnormal growth of endometrial tissue outside the uterine cavity, but in rare cases may also occur on the skin. Cutaneous endometriosis frequently develops at the site of a prior abdominal or pelvic procedure, although apparent spontaneous occurrence has been reported. We present a case of non-symptomatic, cutaneous endometriosis in the episiotomy scar. The patient had no evidence of concurrent pelvic endometriosis.

A Case of Cutaneous Endometriosis / 대한피부과학회지

Endometriosis is defined as the growth of endometrial tissue outside the uterine cavity and its occurrence is usually related anatomically to the uterus and its attachments. Cutaneous endometriosis occurs most commonly as a secondary process in scars after abdominal or pelvic procedures including hysterotomy, hysterectomy, cesarean section, episiotomy, and laparoscopy. Because of the rarity of cutaneous endometriosis, and the failure of the recognition of the correlation between the intensity of the pain and the menstrual cycle, the diagnosis can be easily missed. We present a case of cutaneous endometriosis occurred in the scar of a previous cesarean section in a 27-year-old woman.