Umbilical nodule, a rare presentation of primary cutaneous endometriosis: Case report and literature review.

Umbilical endometriosis or Villar's nodule is defined as the presence of endometrial tissue within the umbilicus and represent 0.5%-1% cases of endometriosis ectopia. It is classified as primary or secondary based on the surgical history. The important symptoms that characterize primary umbilical endometriosis were cyclical pain and a palpable mass that may be associated with bleeding. These features have temporal association with catamenia. Presented is a 30 year old woman with clinical features that suggested primary umbilical endometriosis in the past 5 years. It was confirmed by histology and coexisted with uterine fibroid. In the absence of previous surgery, primary umbilical endometriosis should be considered in the differential diagnosis in females of reproductive age with umbilical pain and nodule related to catamenia. Surgery is the treatment of choice and this should be individualized as some lesions can be managed by local excision with satisfactory outcome regarding the cessation of the presenting symptoms with good cosmetic outcome.

Jejunojejunal intussusception induced by a gastrointestinal stromal tumor: a case report and literature review.

Intussusception is defined as the invagination of a proximal segment of the bowel into the adjoining or distal segment. In most adults with intussusception, there is a demonstrable lead point with a definite pathologic abnormality. The clinical features of intussusception include chronic intermittent abdominal pain, nausea and vomiting, constipation, and a palpable abdominal mass. The present case report describes a 62-year-old woman with a 2-week history of abdominal pain and 9-day history of vomiting. Clinical, imaging, and histologic evaluations revealed a jejunojejunal intussusception with a gastrointestinal stromal tumor as the lead point. A gastrointestinal stromal tumor should be considered as a possible lead point in adult patients with intussusception. The implication of reducing the intussusception prior to tumor resection requires further evaluation in view of the risk of venous embolism, including direct spread of malignant cells, in cases involving a large polypoid mass with a necrotic surface that extends to the serosa as shown by intraoperative examination. Accordingly, the rationale for adjuvant therapy with imatinib also requires further evaluation.