case_images: PMC5055931_01
case_images: Umbilical nodule bleeding during menstrual cycle.
case_images: CRIOG2016-7401409.001.jpg
case_images: PMC5055931_01_CRIOG2016-7401409.001.jpg
case_images: fig1
case_images: The nodule was painless and the patient mentioned cyclical umbilical bleeding synchronized with menstruation (Figure 1), during withdrawal bleeding.
case_images: Umbilical nodule.
case_images: CRIOG2016-7401409.002.jpg
case_images: PMC5055931_01_CRIOG2016-7401409.002.jpg
case_images: fig2
case_images: At physical examination, she had a soft swelling nodule, with two bluish-purple dots, in the umbilicus with a diameter of 1.2 cm, with a normal skin envelope, that was irreductible (Figure 2).
case_images: MRI: T2-weighted imaging. (a) Coronal view. (b) Axial view: uterus with multiple small nodules regarded as leiomyomas and with some endometrial glands suggesting adenomyosis.
case_images: CRIOG2016-7401409.003.jpg
case_images: PMC5055931_01_CRIOG2016-7401409.003.jpg
case_images: fig3
case_images: Magnetic resonance imaging (MRI) showed uterus measuring 92 x 40 x 58 mm, with multiple small nodules showing signal hypointensity on T2-weighted imaging regarded as intramural leiomyomas and the presence of some endometrial glands suggesting adenomyosis, endometrium with 6 mm (Figure 3).
case_images: MRI: T2-weighted imaging. (a) Sagittal view. (b) Coronal view: left ovarian cyst.
case_images: CRIOG2016-7401409.004.jpg
case_images: PMC5055931_01_CRIOG2016-7401409.004.jpg
case_images: fig4
case_images: MRI also revealed a left septated ovarian cyst measuring 40 x 33 mm and a second cyst of 28 x 18 x 24 mm, containing fluid showing signal hyperintensity on T1-weighted imaging and slightly signal hyperintensity on T2-weighted imaging, suggesting hemorrhagic cyst or endometrioma (Figure 4).
case_images: Umbilical nodule resected.
case_images: CRIOG2016-7401409.005.jpg
case_images: PMC5055931_01_CRIOG2016-7401409.005.jpg
case_images: fig5
case_images: The nodule was supra-aponeurotic with central extension (hernial ring) to the abdominal peritoneum (Figure 5).