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Tracing the Journey of Endometrium, from Womb to Arm: Deltoid Endometriosis

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Abstract

Background

Endometriosis is an enigma. Extrapelvic endometriosis is even more challenging, as theories of origin are difficult to explain. Very few cases of skeletal endometriosis have been reported in the literature.

Method

We managed a case of 39-year-old nulliparous woman, who presented to the department of plastic surgery with complaints of a painful nodule measuring about 2 cm, in left upper arm since past 8 years. She had history of myomectomy 8 years back, while she was undergoing treatment for primary infertility. Differential diagnosis of extrapelvic endometriosis was made based on clinical history of cyclical pain and swelling, and she was referred to gynecology for hormonal treatment. MRI and FNAC were inconclusive. She underwent excision biopsy of the lesion.

Result

Histopathology confirmed intramuscular endometriosis of left deltoid with positive margins. Postoperatively, she was started on dienogest 2 mg once daily and LNG IUS was inserted. Both were withdrawn a year later, due to side effects. It has been more than 6 months since removal of LNG IUS, and currently she is asymptomatic.

Conclusion

To the best of our knowledge, this is the third case of deltoid endometriosis reported till date.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Gynecology Office, F Block, 3rd Floor, Nehru Hospital, Chandigarh, India

    Japleen Kaur, Aashima Arora & Rashmi Bagga

  2. Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Sunil Gaba

  3. Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Pulkit Rastogi

Authors
  1. Japleen Kaur
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  2. Aashima Arora
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  3. Sunil Gaba
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  4. Pulkit Rastogi
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  5. Rashmi Bagga
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Corresponding author

Correspondence to Aashima Arora.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

Ethical approval was not applicable for the purpose of this case report, as it was only observational in nature, and no experimental procedure was performed for the patient.

Informed Consent

Informed consent was obtained from the patient for publication of this case study.

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Japleen Kaur MD, DNB is the Medical Officer (qHPV Project) in the Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India; Aashima Arora MD is the Assistant Professor of Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India; Sunil Gaba MS, MCh is the Additional Professor of Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India; Pulkit Rastogi MD, DM is the Assistant Professor of Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India; Rashmi Bagga MD, DNB is the Professor of Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

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Kaur, J., Arora, A., Gaba, S. et al. Tracing the Journey of Endometrium, from Womb to Arm: Deltoid Endometriosis. J Obstet Gynecol India 70, 529–532 (2020). https://doi.org/10.1007/s13224-019-01292-6

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  • DOI: https://doi.org/10.1007/s13224-019-01292-6

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