Subcutaneous endometrial deposit: an unusual cause of right iliac fossa pain
Bibliographic record
Abstract
A 35-year-old woman presented to hospital with a 7-day history of worsening right iliac fossa pain. The patient reported a 7-month history of intermittent right iliac fossa pain, associated with a palpable nodule in the right iliac fossa. This nodule showed apparent increase in size and tenderness, on palpation, during her menses. Twelve months previously, the patient had undergone a caesarean section. Plain film of the abdomen was unremarkable. Ultrasound examination using a high frequency probe (7.5 MHz) showed a 2 cm nodule in the subcutaneous fat of the anterior abdominal wall superficial to the right rectus abdominus musculature which was hypoechoic relative to adjacent subcutaneous fat and of inhomogenous echotexture with low level internal hyperechoic echoes. Doppler interrogation showed a single vascular pedicle entering the mass at the periphery (Figure 1a). The margins were slightly irregular. There were no ultrasound features of incisional hernia. Computed tomography with intravenous and oral contrast revealed a 2 cm solid, slightly spiculated nodule, located in the subcutaneous fat without involvement of the anterior abdominal wall musculature and parallel to the Pfannensteil incision (Figure 1b). The nodule was hyperdense compared to rectus abdominus musculature following intravenous contrast enhancement, measuring approximately 80 Hounsfield units. There was minimal stranding of the surrounding subcutaneous fat. Differential diagnosis included haematoma, abscess, sebaceous cyst, enlarged lymph node, desmoid tumour, and malignant tumours such as malignant melanoma, or metastatic breast or renal cell carcinoma. Percutaneous biopsy using a 17 gauge coaxial needle system was performed under ultrasound guidance (Figure 2a). Histopathological examination confirmed endometrioma (Figure 2b).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".