Endometriosis umbilical primaria: reporte de caso

La endometriosis umbilical primaria es un fenomeno raro que representa el 0,4 % - 1,0 % de la endometriosis extra-genital. A pesar que la mayoria de los casos presentan sangrado umbilical junto a tumoracion palpable, el diagnostico a menudo se retrasa debido a su baja prevalencia. Su patogenesis exacta aun no esta determinada. La distincion clinica entre endometriosis umbilical primaria y otros tumores umbilicales es dificil. La extirpacion completa y la histologia son necesarias para obtener el diagnostico definitivo y poder tratarla de forma optima. Se presenta un caso de paciente de 20 anos con sangrado espontaneo por el ombligo que coincidia con los ciclos menstruales. La paciente no tenia antecedentes de procedimientos quirurgicos. El examen clinico revelo una tumoracion firme de 3 x 2 centimetros a 1 centimetro en forma caudal al ombligo y de color rojo – violacea. Los estudios de imagen mostraron tumoracion umbilical sin conexion a organos abdominales o pelvicos. La lesion cutanea fue extirpada por escision amplia y completa. La biopsia mostro estructuras glandulares dilatadas en la dermis rodeada de estroma endometrial e infiltracion perivascular de linfocitos, confirmando el diagnostico de endometriosis umbilical primaria. Primary umbilical endometriosis is a rare phenomenon that represents 0.4 % - 1.0 % of extra-genital endometriosis. Despite the fact that most cases present umbilical bleeding along with a palpable mass, diagnosis is often delayed due to its low prevalence. Its exact pathogenesis is not yet determined. Clinical distinction between primary umbilical endometriosis and other umbilical tumors is difficult. Complete excision and histology are necessary to obtain the definitive diagnosis and be able to treat it optimally. We present the case of a 20-year-old patient with spontaneous bleeding through the umbilicus that coincided with menstrual cycles. The patient had no history of surgical procedures. Clinical examination revealed a firm mass of 3 x 2 centimeters to 1 centimeter caudal to the umbilicus and red-violaceous. Imaging studies showed an umbilical tumor without connection to abdominal or pelvic organs. A skin lesion was excised by wide and complete excision. The biopsy showed dilated glandular structures in the dermis surrounded by endometrial stroma and perivascular lymphocyte infiltration, confirming diagnosis of primary umbilical endometriosis.