Rahman NA, Shope T. Cyclically bleeding trocar-site endometrioma without known history of endometriosis: case report and literature review.
J Surg Case Rep 2022;
2022:rjac498. [PMID:
36389442 PMCID:
PMC9659428 DOI:
10.1093/jscr/rjac498]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/06/2022] [Indexed: 01/25/2023] Open
Abstract
Endometriosis occurrence at a laparoscopic trocar-site incision is extremely rare with only 30 previous cases published. We present a 43-year-old female with surgical history of two cesarean sections and a laparoscopic Roux-en-Y gastric bypass who presented with history of cyclical bleeding from an umbilical mass coinciding with her menstrual cycle. Ultrasound demonstrated a complex solid and cystic lesion measuring 2.5 x 1.4 x 1.4 cm. This umbilical mass was surgically resected and gross examination perioperatively demonstrated dark-colored cystic implants consistent with endometrioma. Pathology confirmed the suspected diagnosis of endometriosis. There are several noteworthy characteristics in this unique case of laparoscopic trocar-site endometrioma. Umbilical bleeding is an unusual presenting symptom that has not been previously reported. This endometrioma occurred at the umbilical laparoscopic site rather than her Pfannenstiel incision. Laparoscopic Roux-en-Y gastric bypass has not been previously associated with trocar-site endometrioma. Of note, this patient had no known history of endometriosis.
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