Presentation
Abdominal wall lump.
Patient Data
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Patient scanned in decubitus position for comfort. Supraumbilical nodule, which is heterogeneous on T1, high on T2FS and demonstrates enhancement on T1C+FS sequences. It abuts the rectus sheath but there is no extension into the peritoneal cavity.
The patient proceeded to ultrasound guided percutaneous core biopsy.
Histopathology
MACROSCOPIC DESCRIPTION: "Abdo Bx core": Five white and brown needle cores between 2 & 15mm.
MICROSCOPIC DESCRIPTION: The fragments consist mostly of vascular but mature fibrous tissue. Scattered amongst this tissue are proliferative endometrial glands with underlying endometrial stromal tissue. There is no evidence of malignancy.
DIAGNOSIS: "Abdo Bx core": Endometriosis.
Case Discussion
Umbilical endometriosis has been reported as both primary (i.e. spontaneous) and secondary (e.g. secondary to laparoscopic surgery). This patient did not report a history of surgery and examination did not reveal any surgical scars. This may be a case of primary umbilical endometriosis, although this is a very rare diagnosis with <50 cases published in the literature.
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