{"paper_id":"25506313-6750-430b-96e5-fc102d5c869c","body_text":"1\nInternational Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594832406092\nInternational \nJournal of\nHealth \nScience\nv. 4, n. 83, 2024\nAll content in this magazine is \nlicensed under a Creative Com -\nmons Attribution License. Attri -\nbution-Non-Commercial-Non -\nDerivatives 4.0 International (CC \nBY-NC-ND 4.0).\nPRIMARY UMBILICAL \nENDOMETRIOMA OR \nVILLAR NODULE: A \nCASE REPORT\nLuana Poubel Marques da Silva\nAna Paula Pontes Jacques\nhttp://lattes.cnpq.br/2224231044134976\nAline Durão de Andrade Pequeno\nhttp://lattes.cnpq.br/9825303351084755\nBianca Ribas Lee Santana\nhttp://lattes.cnpq.br/6802697245465026\nCaroline Beling\nhttp://lattes.cnpq.br/5114783935854302\nY asmin Gabriel dos Santos\nhttp://lattes.cnpq.br/0631639249737787\nIsabella Georges Pelógia Farah Trigo\nhttp://lattes.cnpq.br/5083929370726427\nLuiza Lopes Ventura Cabral\nhttp://lattes.cnpq.br/4081005855123440\n\n \n2\nInternational Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594832406092\nINTRODUCTION\nEndometriosis is characterized by the \npresence of endometrial glands outside the \nuterine cavity, affecting around 10-20% of \nwomen of reproductive age. Among its sites, \nthe skin surface accounts for 1% of cases, with \nthe umbilical scar being the most common \nsite.Also known as Villar’s nodule, this \npathological condition manifests as a purple \nor red nodule, of variable diameter, associated \nwith cyclical pain with or without bleeding. It \ncan be primary or secondary, the former being \nmore common and found in patients with no \nsurgical history and the latter in women who \nhave undergone conventional or laparoscopic \nsurgical procedures. Its treatment consists \nof radical resection with wide local excision. \nThis article aims to discuss the diagnosis and \nmanagement of umbilical endometrioma, \nsometimes referred to the general surgeon as \numbilical hernia.\nCASE REPORT\nA 47-year-old female patient with no \nsurgical history or documented history of \nendometriosis was admitted to the general \nsurgery department of the Military Police \nCentral Hospital with a swelling on her \numbilical scar. She reported gradual growth \nover the last two years, associated with pain \nand minor bleeding during menstrual periods. \nThe lesion was brownish in color, with small \nwine-colored nodules, bleeding on palpation \nand measuring around 2.0 cm in diameter. \nDue to the cyclical nature of the pain, \nwhich correlated with her menstrual cycle \nand topography, umbilical endometriosis \nwas suspected. The initial differential \ndiagnosis included simple inclusion cyst, \ngranuloma and umbilical hernia. A computed \ntomography scan of the abdomen suggested \numbilical endometrioma. Surgical resection \nwith omphaloplasty was carried out without \ncomplications and the diagnostic hypothesis \nwas confirmed by a histopathological study \nof the specimen. The patient was followed up \nfor over a year without macroscopic umbilical \nrecurrence. She is currently in perimenopause, \nundergoing conservative therapy with the use \nof oral contraceptives, and is being followed \nup clinically by the gynecology team due to the \nidentification of new asymptomatic pelvic foci \nof endometriosis shown on complementary \nmagnetic resonance imaging.\nEndometrioma: focus of endometrioma near \nthe epidermis of the umbilical region\nCOMMENTS\nSingle-block surgical resection of the \naponeurosis and peritoneum is the treatment \nof choice, reducing local recurrence. \nIf possible, pelvic evaluation of other \nendometrial foci should be carried out with \nmagnetic resonance imaging or laparoscopy. \nCombined oral contraceptives and progestins \nare used as long-term therapy to reduce the \nstimulation and inflammatory effects of \nendometriotic implants. This report highlights \na perimenopausal patient with a primary \numbilical endometrioma and demonstrates a \nrare differential diagnosis that is nevertheless \nrelevant to umbilical surgical pathologies. A \nmultidisciplinary approach can help increase \naccess to diagnosis, reduce morbidity and add \nquality of life to the affected population.","source_license":"CC0","license_restricted":false}