Cyclically bleeding trocar-site endometrioma without known history of endometriosis: case report and literature review. Issue 11 (14th November 2022)

• Record Type: Journal Article
• Authors: Rahman, Naveed A; Shope, Timothy
• Is Part Of: Journal of surgical case reports. Volume 2022:Issue 11(2022)
• Publication Date: 2022-11-14
• Subjects: Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjac498
• Languages: English
• ISSNs: 2042-8812

Abstract

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.