We report a rare case of adenocarcinoma confined to the umbilicus. A 60-year-old menopausal woman presented with an umbilical lump of four years. Excision biopsy showed adenocarcinoma with an appearance suggestive of metastasis from an ovarian cystadenocarcinoma. Tumour markers for ovarian malignancy were normal. Computer tomography did not reveal any evidence of ovarian malignancy. She defaulted on follow-up. After five years, she presented with a 6-cm irregular periumbilical mass. She agreed to undergo an excision biopsy of the mass with total abdominal hysterectomy and bilateral salpingo-oopherectomy with omentectomy. The frozen section of the tumour showed papillary adenocarcinoma. Histology showed adenocarcinoma favouring serous cancer. There was no tumour seen in the ovaries, uterus and omentum. On follow-up, there was no disease recurrence. The patient has been disease-free for two years post surgery. (+info)
Umbilical endometriosis, our experience.
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BACKGROUND: Endometriosis is the presence of functioning endometrial tissue outside the uterine cavity. Umbilical endometriosis has been reported in more than one hundred cases and the umbilicus represents the location of 0.5-1% of ectopical endometrioses. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. PATIENTS AND METHODS: We report our experience in preoperative differential diagnosis and treatment of four cases of umbilical endometriosis. An accurate anamnesis and clinical examination together with the use of 13 MHz probe ultrasonography with echocolor duplex scan led us to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. RESULTS AND CONCLUSION: In all treated cases, a hemi-circumferential incision in the inner aspect of the umbilical opening was performed allowing adequate access to the lesion and umbilical repositioning. At the follow-up visit (from 6 to 24 months after surgery), no symptoms or signs of recurrence were evidenced. A natural-looking umbilicus was observed in all cases with minimal visible scars. (+info)