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Cutaneous endometriosis is a rare manifestation of endometriosis, and few reports on its dermoscopic features have been published. In this case report, we present a 40‐year‐old female with cutaneous endometriosis arising in a caesarean scar, exhibiting unique and distinct dermoscopic features. The patient presented with a nodular, papillomatous growth in the right end of the scar, and dermoscopic examination revealed structureless red papillomatous projections, as well as nonpapillomatous areas with red dotted vessels surrounded by a white reticular network. A biopsy confirmed the diagnosis of endometriosis. To our knowledge, this is the first report of such dermoscopic features in cutaneous endometriosis arising in a caesarean scar. Our case report adds to the current limited knowledge of dermoscopic features of cutaneous endometriosis and may help in the diagnosis of this condition. [ABSTRACT FROM AUTHOR]

The authors describe the case of a 24-year-old woman with a painful nodule in the umbilical area, lasting more than one year and enlarging with time. After excision and histological examination, the diagnosis of cutaneous endometriosis was confirmed. The patient was subsequently examined at the gynecological clinic, where regular follow-up visits with ultrasound examinations were recommended, without the need of further therapy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cutaneous endometriosis is a rare disease in dermatology; a welldefined lesion is called endometrioma. This is defined as the presence of endometrial tissue, glands and stroma outside the uterine cavity. Its uterine version affects 12% of women. The usual location is intrapelvic but the cutaneous form can be primary, although most cases are due to surgical procedures demonstrated in the uterus or fallopian tubes, mainly hysterotomies due to abortion. CLINICAL CASE: A 43-year-old female patient who consulted for "abdominal mass" of three years of evolution. Physical examination revealed a dermatosis located on the trunk that affected the abdomen in the infraumbilical region. Characterized by a multilobulated exophytic neoformation, with a sessile base, well-defined borders, red-violet coloration, with a history of three pregnancies, two of them resolved by transperitoneal segmental cesarean section. The histopathological study identified endometrial glands accompanied by a stroma similar to the endometrial, in the thickness of the dermis, multiple glandular lights accompanied by an abundant moderately cellular and highly edematous stroma. The glandular lumens are lined by a tall columnar epithelium of cells with basophilic cytoplasm and a large, vesicular nucleus located in the basal portion of the cells. It was decided to refer to gynecology for resection with wide margins. CONCLUSIONS: Cutaneous endometriosis is a rare disease, which is worth considering a differential diagnosis, since it can be confused with diagnoses such as pyogenic granuloma or even amelanotic melanoma. [ABSTRACT FROM AUTHOR]

Abstract is missing (Quiz)

Cutaneous endometriosis is a disorder that primarily affects women of reproductive age. The disorder is most commonly associated with cyclical pain during menses, but it can be difficult to diagnose in the absence of these symptoms and requires biopsy testing for a definitive diagnosis. We report on a case of a 41-year-old patient undergoing hormonal therapy for infertility who presented with a painful firm subcutaneous nodule in the umbilicus. She was ultimately diagnosed with cutaneous endometriosis and underwent surgical excision. In this report, we discuss the differential diagnosis and comment on treatment options, including surgical excision with wide margins or treatment with hormonal agents, such as danazol or leuprolide. Finally, we discuss whether patients with cutaneous endometriosis should receive an additional evaluation for pelvic endometriosis.

Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity. Abdominal wall or cutaneous endometriomas are quite uncommon with an incidence of less than 1%. Abdominal wall endometrioma can occur in a previous surgical scar, commonly following obstetrical and gynecological surgeries. Cutaneous endometriosis is difficult to diagnose because of its nonspecific symptoms and is often confused with other dermatological and surgical diseases thereby delaying the diagnosis and management. We are reporting a case of scar endometriosis at the site of previous cesarean scar involving the rectus sheath. The pathogenesis, diagnosis, and treatment of this rare condition are being discussed. Awareness of the clinical features and presentation of this rare condition is essential for timely diagnosis and management.

Abstract Background Umbilical endometriosis is a rare entity accounting for 0.5–4% of cases with endometriosis. Case presentation Here we report a rare case of umbilical endometriosis with concurrent ovarian endometriomas in a 37-year old primiparous Iranian woman. Conclusion This interesting coexistence reflects the importance of thorough gynecological assessment in patients with cutaneous endometriosis to enable appropriate management.

Endometriosis is an inflammatory disease associated with pelvic pain and infertility that is characterized by lesions of endometrial-like tissue outside of the uterus. It affects roughly 10 % of reproductive age women and girls globally. Umbilical endometriosis is a rare pathology accounting for 0.5 to 1 % of all extra-pelvic endometriosis. Due to the varied presentations and rare incidence of endometriosis, it remains a diagnostic dilemma and challenge to treat it timely and properly. A 32-year-old nulliparous lady who presented with umbilical lump, cyclical pain, and bleeding during menstrual cycle without any prior history of abdominal surgery of a year duration. Ultrasound and magnetic resonance imaging support the diagnosis of umbilical endometriosis and ruled out multifocal involvement. She was managed with surgical excision with free margin followed by umbilical reconstruction and the diagnosis was confirmed by biopsy. Umbilical endometriosis could be either secondary to endometrial tissue implantation during laparoscopic or open surgical procedures also called scar endometriosis or as a primary umbilical endometriosis with no previous surgery. The characteristic presentation for umbilical endometriosis is a brown to dark nodule in the umbilicus, which may be swollen, painful, and sometimes bleed during menstrual periods. Umbilical endometriosis is a rare condition that should be considered as a differential diagnosis in women with umbilical lump, cyclical pain, and bleeding. The diagnosis is clinical and confirmed by histopathology. Surgical excision is the treatment of choice with a low risk of recurrence or malignancy. • Umbilical endometriosis is a rare pathology accounting for 0.5 to 1 % of all extra-pelvic endometriosis. • The diagnosis is clinical and confirmed by histopathology. • Misdiagnosis for other pathologies like pyogenic abscess is common due to lack of high suspicion of this pathology. • Though medical management is an option, complete nodule excision with free margin is recommended to prevent recurrence. [ABSTRACT FROM AUTHOR]

Abstract Primary umbilical endometriosis is unusual clinical presentation of endometriosis. Its diagnosis can be challenging due to lack of knowledge. This condition should be listed in the differential diagnosis of umbilical disorders.

Endometriosis is the presence of ectopic endometrial tissue outside the uterus and cutaneous endometriosis is a rare manifestation of this disease that may be found at the sites of surgical scars as a result of iatrogenic implantation. Herein we present a case of scar endometriosis in a 35-year-old woman. The scar was sustained following a remote caesarean section.

BACKGROUND: Cutaneous endometriosis is a rare, generally benign disorder that belongs to the extrapelvic endometriosis. CLINICAL CASES: This paper reports the case of five female patients with cutaneous endometriosis. The first case presented endometriosis secondary to pelvic surgery, probably because of the iatrogenic or hematogenic implantation of endometrial cells during the surgical act. The rest of the cases presented sporadic cutaneous endometriosis, which is an extremely rare affection of unknown etiopathogenesis. CONCLUSIONS: In the sporadic cases, the umbilical location is the most frequent. Since 25% of the patients with sporadic cutaneous endometriosis presents pelvic endometriosis, it is important to highlight the detailed gynecological follow-up with complementary studies. [ABSTRACT FROM AUTHOR]

Background: Umbilical endometriosis is a rare entity accounting for 0.5–4% of cases with endometriosis. Case presentation: Here we report a rare case of umbilical endometriosis with concurrent ovarian endometriomas in a 37-year old primiparous Iranian woman. Conclusion: This interesting coexistence reflects the importance of thorough gynecological assessment in patients with cutaneous endometriosis to enable appropriate management. [ABSTRACT FROM AUTHOR]

Objective: Cesarean scar endometriosis (CSE) is the presence of ectopic endometrial tissue at the site of the previous cesarean section (CS) scar. The prevalence varies between 0.04 and 0.53. We aimed to evaluate the women with CSE in the past 10 years in Niğde. Materials and Methods: The medical records of Ömer Halisdemir University Training and Research Hospital and the single private hospital were retrospectively analyzed through electronic databases between January 2010 and January 2020. Pathological reports with the diagnosis of abdominal wall endometriosis were distinguished. The ones excised from a CS scar were included into the study. For each patient clinical, obstetric and surgical characteristics were recorded. Results: Forty women were included into the study with an average age of 31.6±5.9 years. The diameter of the CSE lesion was positively correlated in medium strength with body mass index (BMI) at the time of CS (r=0.448, p=0.019). Similarly, the diameter of the lesion and weight gain during pregnancy was correlated in medium strength (r=0.423, p=0.014). The onset of symptoms was correlated in medium strength with lactation period (r=0.539, p=0.001). The rate of correct initial diagnosis was significantly higher in years 2015–2019 than in years 2010–2014 (p=0.004). The CSE prevalence was 0.15 in the present study. Conclusion: High BMI values at the time of CS and weight gain during pregnancy might be contributors of CSE development. Furthermore, lactation might have protective effects against CSE. [ABSTRACT FROM AUTHOR]

Endometriosis is a pathology little referenced in the dermatological literature and is defined as the presence of endometrial tissue outside the uterus. When it is a well-defined mass of endometriosis it is called endometrioma. Cutaneous endometriosis is one of the rare gynecological conditions. Cutaneous endometriosis is a disorder that primarily affects women of reproductive age. The disorder is most commonly associated with cyclical pain during menses, but it can be difficult to diagnose in the absence of these symptoms and requires biopsy testing for a definitive diagnosis. We report on a case of a 39-year-old patient who presented with pain at the cearean section scar. She was ultimately diagnosed with cutaneous endometriosis and underwent surgical excision. [ABSTRACT FROM AUTHOR]

Introduction: Endometriosis involving a surgical scar occurs in 1%–2% of patients after cesarean section. There are three theories of pathogenesis: direct seeding of endometrium during surgery, distal migration by hematogenous or lymphatic routes, and scar tissue metaplasia. Retrograde menstruation, theorized to result in local pelvic endometriosis, has not been previously described to play a role in surgical scar endometriosis. Case report: A 36-year-old woman presented with a catamenial painful nodule in her cesarean section scar. She underwent laparoscopy with lysis of adhesions and excision of the abdominal wall nodule. The fimbriated end of the right fallopian tube was scarred to her abdominal wall at the site of the nodule, and chromopertubation proved direct communication between the painful nodule and the fallopian tube. Pathology confirmed surgical scar endometriosis. Conclusion: Retrograde menstruation remains a possible theory for pathogenesis of endometrial scar endometriosis, and laparoscopy should be considered at the time of resection when pelvic pain is present. [ABSTRACT FROM AUTHOR]

Primary umbilical endometriosis is unusual clinical presentation of endometriosis. Its diagnosis can be challenging due to lack of knowledge. This condition should be listed in the differential diagnosis of umbilical disorders. [ABSTRACT FROM AUTHOR]

Abstract: Background: Cutaneous endometriosis (CE) is rare and its dermoscopic features were reported only in 3 patients. The aim of this study was to examine a case of pigmented CE with multiple non‐invasive imaging techniques, to compare the obtained images with histopathology and to define their utility in an early diagnosis of the disease. Case report: We performed dermoscopy, high‐frequency ultrasound (HFUS), in vivo and ex vivo reflectance confocal microscopy (RCM) of a pigmented CE arising on the caesarean scar of a phototype IV patient, along with histologic studies. Dermoscopy showed a greyish background and a brownish pigmentation. HFUS shows well‐demarcated anechoic areas corresponding to ectopic endometrial tissue at histopathologic examination. RCM and OCT only showed the alterations of the epidermis. Conclusion: High‐frequency ultrasound could represent a very useful tool for an early diagnosis of CE and its usefulness could be tested in patients with unusual cyclical pain, even before skin lesion appearance. RCM allowed the visualization of skin surface modification due to underlying endometriosic tissue. Dermoscopy showed a new aspect that was probably related to the mix of blood extravasation (ie, greyish background) and epidermal pigmentation (ie, brown pigmentation). [ABSTRACT FROM AUTHOR]

Objective: Cutaneous endometriosis is a rare condition that usually affects the abdominal wall in women with a history of open abdominal surgery. It has a characteristic clinical picture of a mass and pain associated with menstruation. The diagnosis is difficult on being an uncommon and little known condition. Once there is suspicion, a correct anamnesis and examination is usually sufficient. The treatment is normally surgery.Study Design: The study included all women identified with a diagnosis of cutaneous endometriosis over a period of 20 years. The variables collected and analysed included, age, surgical history, gynaecology history, symptoms, time period between surgery and consultation, specialist consulted, location, size, tests performed, treatment, and recurrence.Results: A total of 33 women were identified, with a mean age of 35.4 ± 2.33 years. A surgical history was found in 31 (93%) of 33 women. The main symptom was abdominal mass (96%), followed by period pain (51%), and non-period pain (42%). The initial diagnosis was correct in 15 (45%) of 33 women, and after performing further tests it was correct in 23 (69%) of 33 women. The main additional test was fine needle aspiration (FNA) in 24 (72%) of 33 patients. Surgery was performed on 30 (90%) of 33 women, with 8 (24%) women requiring a prosthesis. There was a recurrence of cutaneous endometriosis in 3 (9%) women.Conclusion: Although it is a rare disease, its association with gynaecological surgery, and in particular caesarean section, means that there should be more awareness of this condition. Its diagnosis may be complicated due to lack of knowledge, when a proper examination and anamnesis can give us the key. [ABSTRACT FROM AUTHOR]

Cutaneous endometriosis that arises de novo, without a prior history of surgery, is a rare phenomenon. The clinical diagnosis of cutaneous endometriosis remains challenging due to the variable clinical appearance and symptoms of the condition, and therefore must be considered in the differential diagnosis of any umbilical lesion. We report a 31-year-old woman who presented with spontaneous cutaneous endometriosis of the umbilicus.

Background: Cutaneous endometriosis is usually associated with a preceding surgical scar; spontaneous cutaneous endometriosis is rare. We report on a case of spontaneous cutaneous endometriosis of the mons pubis as well as a review of the literature. Case: A 46-year-old woman with no surgical history presented to gynecology clinic with a 6-year history of a mass on the mons pubis causing severe cyclic pain with enlargement during menses. Initial fine needle aspiration biopsy was nondiagnostic; thus, pelvic ultrasound, magnetic resonance imaging, and a core needle biopsy were used to diagnose a mons endometrioma. The lesion was surgically excised with pathology confirming the diagnosis. The patient noted subsequent improvement in her symptoms. Conclusion: Spontaneous cutaneous endometriosis of the mons pubis can be successfully treated via surgical excision. [ABSTRACT FROM AUTHOR]

It is difficult to conduct studies with larger series in rarely observed diseases. We report our experience in managing cesarean scar endometriosis (CSE) and emphasize the diagnosis and treatment options. The objective of our study is to review the clinical characteristics of CSE and to evaluate our surgical outcomes. We have collected and documented a case series of 12 patients who underwent surgical wide en bloc excision with surrounding clear margins for CSE. Patients' demographic features, symptoms, and clinical and operative findings were evaluated. The mean age was 34.6 years. Cyclical pain was documented in seven patients, while three patients presented with noncyclical pain. Menstrually-related enlargement of the nodule was observed in four patients, and only one patient had a complaint of dark brown leakage. The mean operation time was 26 min. The endometriotic lesions ranged from a diameter of 2 to 8 cm in size. Patients recovered completely, and no recurrence was observed. To prevent iatrogenic transplantation, additional attention is needed during surgery that exposes endometrial tissue. Complete wide excision of CSE is both diagnostic and therapeutic. To avoid unnecessary referrals, awareness of its typical clinical manifestations remains the mainstay for intervention. The most important issues to be considered during surgery is nonspreading endometriosis while manipulation. [ABSTRACT FROM AUTHOR]

Background: Endometriosis nodes are observed in extra pelvic locations, particularly in gynaecological scars, with the abdominal wall being one of the most frequent locations. The main objective of the study is to review patient characteristics of cases of endometriosis nodes in gynaecological scars. Methods: A retrospective, observational and descriptive study with a cohort of patients from Hospital 12 de Octubre was conducted from January 2000 to January 2012. We analysed all of the patients who presented with an endometriosis node in a gynaecological scar presentation who had undergone surgery in that period. Descriptive data were collected and analysed. Results: A total of 17 patients with an anatomopathological diagnosis of an endometriosis node in a gynaecological scar were found. The following variables were studied: the age at diagnosis (32.5 years +/- 5.5 years), personal and obstetric history, time from surgery to diagnosis (4.2 years +/- 3.4 years), symptoms (a painful mass that grows during menstruation is the most frequent symptom in our patients), technical analyses by computed tomography (CT), magnetic resonance (MR) or fine needle aspiration (FNA) (77% of the patients), node size (2.5 cm +/- 1.1 cm) and location (caesarean scar, 82%; episiotomy scar, 11.7%; and laparoscopic surgery port, 5.8%), involvement of adjacent structures (29% of the patients), treatment (exeresis with a security margin in all the patients) and other endometriosis locations (14% of the patients). Conclusions: A high level of suspicion is required to diagnose gynaecological scar endometriosis, which should be suspected in the differential diagnosis of scar masses in reproductive-aged women. Several theories have been proposed to explain the formation of endometriosis nodes in extrauterine localizations. The two of them that seem to be more plausible are the metaplasia and transport theories. Imaging with ultrasound, CT and MR facilitate the diagnosis. FNA could be used for preoperative diagnosis. Treatment must be by node resection with a security margin. In some cases, surgery could be combined with hormonal treatment. [ABSTRACT FROM AUTHOR]

Endometriosis is a common disorder in females of reproductive age. Surgical scar endometrioma after cesarean section develops in 1-2 % of patients, and usually presents as a tender and painful abdominal wall mass. The diagnosis is suggested by pre or perimenstrual pelvic pain and is often established only by histology. In this retrospective observational cohort study, we reviewed the medical records of five patients with a histopathological diagnosis of scar endometriosis. A scar mass was found on a previous Pfannenstiel incision in four patients and in a median cesarean section in one patient. The mean age at diagnosis (38.6 years, median 38) was older than reported elsewhere. A histological examination of the surgical specimen confirmed the diagnosis of endometriosis in all cases. During the follow-up period (mean 34.6 months), local recurrence ( n = 1) and pelvic recurrence ( n = 1) were treated surgically. Surgery is the treatment of choice for surgical scar endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. As scar endometriosis may be associated with pelvic localization, explorative abdominal laparoscopy may be indicated to exclude the intraperitoneal spread of the disease in symptomatic patients. [ABSTRACT FROM AUTHOR]

Endometriosis is a condition where endometrial glands and stroma are ectopically located in sites other than the uterine cavity. Cutaneous endometriosis is very rare, representing approximately 1.1% of cases of extrapelvic endometriosis. We report a case of a 44-year-old female with no prior surgical history who presented with multiple tan brown periumbilical nodules. Histopathological examination revealed multiple glandular structures in the dermis with surrounding stroma. Immunohistochemistry cinches the diagnosis, as CD10, estrogen receptor and progesterone receptor are strongly positive in our case. The mainstay of treatment of cutaneous endometriosis is surgical excision of the lesion. Farooq U, Laureano AC, Miteva M, Elgart GW. Cutaneous endometriosis: diagnostic immunohistochemistry and clinicopathologic correlation. [ABSTRACT FROM AUTHOR]

Endometriosis is a condition in which endometrium or endometrium-like tissue grows in areas other than the endometrium and is often found within the pelvis such as in the uterus or ovary, but occasionally develops ectopically in the skin. In this paper, we report a case of cutaneous endometriosis in the umbilical region found in a 37-year-old woman with no history of pregnancy. The lesion was a brown, firm and elastic nodule, 9 mm × 7 mm in size, and caused bleeding as well as pain which increased during menstruation. Histopathological findings revealed that there were small and large glandular cavity structures in the dermis and the edematous interstitium around it. On immunohistochemical staining for estrogen and progesterone receptors, the cellular nuclei of glandular cavity walls were mainly found to be positive for both, and cells in the edematous interstitium around the glandular cavity were positive for CD10. Consequently, we diagnosed this case as cutaneous endometriosis in the umbilical region. CD10 was initially described as a tumor-specific antigen found in acute lymphoblastic leukemia. Recently, the usefulness of CD10 in diagnosing endometriosis in addition to various types of lymphoma or blood cancer has been confirmed, and in our case it also proved to be as useful as estrogen receptor or progesterone receptor in the definitive diagnosis of endometriosis. [ABSTRACT FROM AUTHOR]

Abstract: Background: Abdominal wall endometriosis (AWE) is defined as endometrial tissue superficial to the peritoneum. AWE often is misdiagnosed and referred to surgeons for treatment. We performed a systematic review of published cohorts to quantify demographics, symptoms, and outcomes of patients having AWE. Methods: An English language PubMed search from January 1951 to August of 2006 was conducted using several search terms for endometrioma. Conclusions: Twenty-nine articles describing 455 patients were identified and met inclusion criteria. The pooled mean age was 31.4 years. Ninety-six percent presented with a mass, 87% presented with pain, and 57% presented with cyclic symptoms. AWE was associated with a caesarian scar or hysterectomy in 57% and 11% of cases, respectively. The interval from index surgery to presentation was 3.6 years. Recurrence after resection was 4.3%. The most common presentation of AWE is the development of a painful mass after uterine surgery. Surgical treatment appears to result in a cure more than 95% of the time. [Copyright &y& Elsevier]

Abstract: We report a case of umbilical endometriosis externa and systematically review the literature regarding this finding. In our case report, a 47-year-old woman with cyclic umbilical bleeding, pelvic pain, and no previous umbilical surgery developed a spontaneous umbilical endometrioma, cured by surgical resection and bilateral salpingo-oophorectomy. In our review, 122 patients with documented umbilical endometriomas from 1966 to the present and 109 cases reported before 1953 were analyzed. Procedures used for diagnosis and/or therapeutic intervention included umbilical biopsy or resection, abdominal wall repair, diagnostic and/or operative laparoscopy, adhesiolysis, hysterectomy, and bilateral salpingo-oophorectomy. Variables included patient age; race; medical and surgical history; past use of oral contraceptives; history of umbilical pain, bleeding, or swelling; duration of signs and symptoms; size and color of the lesion; diagnostic evaluations; and medical or surgical management. Mean age of the study population was 37.7 ± 0.98 years. Up to 40% of patients with extrapelvic endometriosis present with umbilical endometriomas, with symptoms occurring an average of 17.8 ± 3.9 months before presentation. Lesions averaged 2.3 ± 0.2 cm in diameter; were predominantly brown (19.1%), blue (13.2%), or purple (10.3%); and patients frequently had with pain (77.93%), cyclical bleeding (47.1%), and swelling (88.2%). Most patients had no history of endometriosis (73.1%), and laparoscopic, umbilical trocar-related seeding was identified in only 5 patients. Three patients received medical management, and surgical management was invariably curative, though 1 patient required repeat surgical therapy. Umbilical endometriosis is a common manifestation of external endometriosis, representing primary or secondary endometriosis, with a typical presentation that has little variation. Laparoscopic endometrioid tissue excision can result in iatrogenic seeding to the umbilicus. Historical and physical findings are pathognomonic, thus justifying a formal name—Villar’s nodule, after the initial reporting physician. Surgical intervention is recommended, but medical therapy may result in long-term symptom control with minimal malignancy risk. [Copyright &y& Elsevier]