臍部に発症した子宮内膜症

Umbilical endometriosis：A case report

　患者は35歳，女性。数年前より，しばしば出血，疼痛を伴う臍部腫瘤を自覚するも放置していた。出血の持続と疼痛の増悪を認め，当院の内科を受診した。尿膜管疾患を疑われ当科に紹介された。腹部CTで，臍直下に約2cm大の充実性腫瘤を認めた。MRIでは，臍部腫瘤と膀胱との連続性は明らかではなかった。臍部腫瘤の経皮的針生検を施行し，臍部子宮内膜症と診断された。血液検査にてCA19-9とCA125の軽度の上昇を認めた。症状の軽快を認めたため，外来で経過観察中である。

We report a 35-year-old woman who presented with a mildly painful,bluish nodule in the umbilicus. Her past medical history and surgical history were unremarkable. Verrucous papules were observed in the umbilical fossa. Urachal cyst was suspected and she was referred to our clinic. Percutaneous needle biopsy of the tumor was performed. The histological features revealed endometriosis. Umbilical endometriosis is rare and can occur after surgery but is generally spontaneous and difficult to diagnose preoperatively. It is important to consider endometriosis for differential diagnosis of umbilical tumors in a woman of sexual activity age.