Menstruating umbilicus: secondary subcutaneous umbilical endometriosis: a rare case report

Rakesh A. Hasabe, Neha S. Tripathi, Prajakta Kesarkodi
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2022 · vol. 11(6) , pp. 1814 · doi:10.18203/2320-1770.ijrcog20221469 · W4281664567
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⚙ AI-generated summary by claude@2026-07, 2026-07-09 ⓘ

This case report details a young nulliparous woman with bleeding umbilical endometriosis, diagnosed via ultrasound and Doppler, and successfully treated with surgical excision.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

This paper reports a rare case of secondary subcutaneous umbilical endometriosis in a 29-year-old nulliparous woman who developed an umbilical nodule at the site of prior diagnostic hystero-laparoscopy port insertion and experienced bleeding from the nodule during menses. Ultrasound and Doppler identified a hypoechoic umbilical mass without associated blood vessels, and the diagnosis was supported by deep surgical excision of the nodule with a 0.5 cm rim of normal skin and umbilical reconstruction under local anesthesia. The authors emphasize that umbilical endometriosis should be included in the differential diagnosis of umbilical disorders even in young nulliparous patients without typical pelvic endometriosis symptoms, and they note that early diagnosis may help avoid more extensive abdominal wall surgery. This paper is centrally about endometriosis—specifically secondary subcutaneous umbilical endometriosis presenting as a “menstruating umbilicus”—with no discussion of adenomyosis.

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Abstract

This paper described a rare case of secondary umbilical endometriosis in a young nulliparous female and its effective diagnosis and treatment. A 29-year-old unmarried female presented with complaints of bleeding during menses from an umbilical nodule that had developed at the port insertion site of a previous diagnostic hystero-laparoscopy. Ultrasound and Doppler examinations confirmed the presence of a hypoechoic mass in the umbilicus with no associated blood vessels. Deep surgical excision of the nodule with a rim of macroscopic normal skin of 0.5 cm all around was performed under local anesthesia and the umbilicus was reconstructed. This case reinforced the concept that umbilical endometriosis should be considered in the list of differential diagnoses of umbilical disorders, even in young nulliparous women with no typical symptoms of pelvic endometriosis. Additionally, it emphasized the importance of early diagnosis of UE in order to avoid extensive abdominal wall surgery.
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Menstruating umbilicus: secondary subcutaneous umbilical endometriosis: a rare case report DOI: https://doi.org/10.18203/2320-1770.ijrcog20221469Keywords: Umbilical endometriosis, Menstruating umbilicus, Subcutaneous umbilical endometriosisAbstract This paper described a rare case of secondary umbilical endometriosis in a young nulliparous female and its effective diagnosis and treatment. A 29-year-old unmarried female presented with complaints of bleeding during menses from an umbilical nodule that had developed at the port insertion site of a previous diagnostic hystero-laparoscopy. Ultrasound and Doppler examinations confirmed the presence of a hypoechoic mass in the umbilicus with no associated blood vessels. Deep surgical excision of the nodule with a rim of macroscopic normal skin of 0.5 cm all around was performed under local anesthesia and the umbilicus was reconstructed. This case reinforced the concept that umbilical endometriosis should be considered in the list of differential diagnoses of umbilical disorders, even in young nulliparous women with no typical symptoms of pelvic endometriosis. Additionally, it emphasized the importance of early diagnosis of UE in order to avoid extensive abdominal wall surgery. Metrics References Efremidou EI, Kouklakis G, Mitrakas A, Liratzopoulos N, Polychronidis AC. Primary umbilical endometrioma: a rare case of spontaneous abdominal wall endometriosis. Int J Gen Med. 2012;5:999-1002. Rosina P, Pugliarello S, Colato C, Girolomoni G. Endometriosis of umbilical-cicatrix: case report and review of the literature. Acta Dermatovenerol Croat. 2008;16(4):218-21. Victory R, Diamond MP, Johns DA. Villar’s nodule: a case report and systematic literature review of endometriosis externa of the umbilicus. J Minim Invasive Gynecol. 2007;14(1):23-32. Falco MD, Ragusa M, Oliva G, Miranda A, Parmeggiani D, Sperlongano P, et al. Is extrauterine endo- metriosis confined to the gynecological sphere? A critical review of the experience in a general surgery unit. G Chir. 2007;28(3):83-92. Spaziani E, Filippo CEO, Picchio M, Briganti M, Cristofano CD, Ceci F, et al. Primary umbilical endometriosis. Clinical case. Giornale Di Chirurgia. 2009;30(5):230-3. Victory R, Diamond MP, Johns DA. Villar’snodule:a case report and systematic literature review of endometriosis externa of the umbilicus. J Minim Invasive Gynecol. 2007;14(1):23-32. Chatzikokkinou P, Thorfinn J, Angelidis IK, Papa G, Trevisan G. Spontaneous endometriosis in an umbilical skin lesion. Acta Dermatovenerol Alp Pannonica Adriat. 2009;18(3):126-30. Kyamidis K, Lora V, Kanitakis J. Spontaneous cutaneous umbilical endometriosis: report of a new case with immunohistochemical study and literature review. Dermatol Online J. 2011;17(7):5. Capasso L, Sciano D, Iarrobino G. L’endometriosi extrauterina: tre nuovi casi. Giornale Di Chirurgia. 2004;25(1-2):39-42. Ferhatoglu MF, Senol K. Primary abdominal wall endo- metriosis: presentation of rarely seen two cases. Il Giornale di Chirurgia. 2018;39(2):107-10. Dunselman GA, Vermeulen N, Becker C, Calhaz‐Jorge C, D’Hooghe T, DeBie B, et al. ESHRE guideline: Management of women with endometriosis. Hum Reprod. 2014;29(3):400‐12. Lauslahti K. Malignant external endometriosis. A case of adenocarcinoma of umbilical endometriosis. Acta Pathol Microbiol Scand Suppl. 1972;233:98-102. Obata K, Ikoma N, Oomura G, Inoue Y. Clear cell adenocarcinoma arising from umbilical endometriosis. J Obstetr Gynaecol Res. 2013;39(1):455-61. Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789-99. Mechsner S, Bartley J, Infanger M, Loddenkemper C, Herbel J, Ebert AD. Clinical management and immunohistochemical analysis of umbilical endometriosis. Arch Gynecol Obstet. 2009;280(2):235-42.

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