Primary Cutaneous Endometriosis of Umbilicus
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
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.
Abstract
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.
참고문헌 (31)
- Minaidou E, "Primary umbilical endometriosis: case report and literature review", Clin Exp Obstet Gynecol, 39, pp.562~564 (2012)
- Yuen JS, "Unusual sites (thorax and umbilical hernial sac) of endometriosis", J R Coll Surg Edinb, 46, pp.313~315 (2001)
- Jaime TJ, "Umbilical endometriosis: report of a case and its dermoscopic features", An Bras Dermatol, 88, pp.121~124 (2013)
- Fernández-Aceñero MJ, "Cutaneous endometriosis:review of 15 cases diagnosed at a single institution", Arch Gynecol Obstet, 283, pp.1041~1044 (2011)
- Weng CS, "Images in clinical medicine. Villar's nodule--umbilical endometriosis", N Engl J Med, 364, pp.e45~ (2011)
- Victory R, "Villar's nodule: a case report and systematic literature review of endometriosis externa of the umbilicus", J Minim Invasive Gynecol, 14, pp.23~32 (2007)
- Groothuis PG, "Adhesion of human endometrium to the epithelial lining and extracellular matrix of amnion in vitro: an electron microscopic study", Hum Reprod, 13, pp.2275~2281 (1998)
- Dadhwal V, "Primary umbilical endometriosis : a rare entity", Arch Gynecol Obstet, 283(Suppl 1), pp.119~120 (2011)
- Theunissen CI, "Primary umbilical endometriosis:a cause of a painful umbilical nodule", J Surg Case Rep, 2015, pp.rjv025~ (2015)
- Calagna G, "Primary umbilical endometrioma: analyzing the pathogenesis of endometriosis from an unusual localization", Taiwan J Obstet Gynecol, 54, pp.306~312 (2015)
- Chikazawa K, "Surgical excision of umbilical endometriotic lesions with laparoscopic pelvic observation is the way to treat umbilical endometriosis", Asian J Endosc Surg, 7, pp.320~322 (2014)
- Pariza G, "Primary umbilical endometriosis (Villar's nodule)-case study, literature revision", Chirurgia (Bucur), 109, pp.546~549 (2014)
- Paramythiotis D, "Concurrent appendiceal and umbilical endometriosis: a case report and review of the literature", J Med Case Rep, 8, pp.258~ (2014)
- Ghosh A, "Primary umbilical endometriosis: a case report and review of literature", Arch Gynecol Obstet, 290, pp.807~809 (2014)
- Gin TJ, "Spontaneous cutaneous endometriosis of the umbilicus", Case Rep Dermatol, 5, pp.368~372 (2013)
- Kahlenberg LK, "Primary umbilical endometriosis presenting as umbilical drainage in a nulliparous and surgically naive young woman", Am J Emerg Med, 32, pp.692.e1~692.e2 (2014)
- Fancellu A, "Primary umbilical endometriosis. Case report and discussion on management options", Int J Surg Case Rep, 4, pp.1145~1148 (2013)
- Efremidou EI, "Primary umbilical endometrioma: a rare case of spontaneous abdominal wall endometriosis", Int J Gen Med, 5, pp.999~1002 (2012)
- Kesici U, "Primary cutaneous umbilical endometriosis", Med Arch, 66, pp.353~354 (2012)
- Bagade PV, "Menstruating from the umbilicus as a rare case of primary umbilical endometriosis: a case report", J Med Case Rep, 3, pp.9326~ (2009)
- Boesgaard-Kjer D, "Primary umbilical endometriosis (PUE)", Eur J Obstet Gynecol Reprod Biol, 209, pp.44~45 (2017)
- Wiegratz I, "Umbilical endometriosis in pregnancy without previous surgery", Fertil Steril, 90, pp.199.e17~199.e20 (2008)
- Taniguchi F, "Primary umbilical endometriosis: unusual and rare clinical presentation", Case Rep Obstet Gynecol, 2016, pp.9302376~ (2016)
- Chew KT, "Primary umbilical endometriosis successfully treated with dienogest", Horm Mol Biol Clin Investig, 29, pp.67~69 (2017)
- Claas-Quax MJ, "Primary umbilical endometriosis", Eur J Obstet Gynecol Reprod Biol, 194, pp.260~261 (2015)
- Sidani MS, "Primary umbilical endometriosis", Clin Exp Obstet Gynecol, 29, pp.40~41 (2002)
- Sengupta M, "Villar's nodule", Online J Health Allied Sci, 10, pp.19~ (2011)
- 김수홍, "피부 자궁내막증 1예", 대한피부과학회지, 40(1) (2002), 대한피부과학회
- Song WK, "A case of cutaneous endometriosis", Korean J Dermatol, 38, pp.999~1001 (2000)
- Kyamidis K, "Spontaneous cutaneous umbilical endometriosis: report of a new case with immunohistochemical study and literature review", Dermatol Online J, 17, pp.5~ (2011)
- Purvis RS, "Cutaneous and subcutaneous endometriosis. Surgical and hormonal therapy", J Dermatol Surg Oncol, 20, pp.693~695 (1994)