Published online Apr 26, 2020. doi: 10.12998/wjcc.v8.i8.1532
Peer-review started: January 19, 2020
First decision: February 26, 2020
Revised: March 9, 2020
Accepted: April 10, 2020
Article in press: April 10, 2020
Published online: April 26, 2020
Abdominal wall endometriosis can occur secondary to gynecological and obstetric pelvic laparotomy; however, this is a rare clinical event. There are few cases of endometriosis involving the incision site of a laparoscopic surgery, especially for those of the endometrial nodule at the umbilical trocar port site where the camera is placed.
We describe the case of a 37-year-old woman who presented with a 2-year history of a tough swelling below the umbilicus, which presented periodical pain during menstruation. The patient had undergone laparoscopic ovarian cystectomy 4 years prior, and we theorized that the umbilical nodule was a complication of that laparoscopic surgery. Histological analysis confirmed the diagnosis of abdominal umbilical scar endometriosis secondary to previous laparoscopic surgery. Surgical removal of the nodule followed by three cycles of leuprorelin was curative.
Abdominal mass and pain in women of childbearing age with a previous history of pelvic surgery should support consideration of endometriosis at the surgical site.
Core tip: Incisional endometriosis after laparoscopy is very rare, and if occurring, it is often seen in the cannula incision of that collected specimen. In our patient, incisional endometriosis occurred in the umbilical cannula incision, which was not the cannula incision from which the specimen was taken out of. We also review the published literature and summarize the characteristics, differential diagnosis, and treatment of umbilical endometriosis.