A Case of Primary Endometriosis Associated With an Umbilical Hernia

Zanan A Odhar, Mustafa Raed Muhi, Mustafa R Muhi, Hasanain Abdulhameed Odhar, Hasanain A Odhar
Cureus · 2022 · vol. 14(8) , pp. e27626 · doi:10.7759/cureus.27626 · PMID:36072205 · W4289517578
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case study describes the diagnosis and surgical management of a rare instance of umbilical endometriosis presenting with cyclical bleeding, confirmed histopathologically in a 40-year-old female without pelvic disease.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper reports a case of primary umbilical endometriosis associated with an underlying umbilical hernia in a 40-year-old woman presenting with cyclical umbilical bleeding for one year, without reported pelvic symptoms and with two prior cesarean sections. Using physical examination and ultrasound, the authors identified a vascular subcutaneous hypo-echoic/heterogeneous mass consistent with an endometrioma alongside a reducible hernia containing bowel, and treated the patient with surgical wide excision of the umbilical lesion and hernia repair plus umbilical reconstruction. Histopathology confirmed endometriosis, and subsequent gynecologic evaluation with pelvic exam and ultrasound found no other abnormalities; the report emphasizes the rarity and diagnostic challenge of this presentation. This paper is centrally about endometriosis — a primary umbilical endometriosis case occurring with an umbilical hernia and diagnosed via imaging and histopathology.

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Abstract

Endometriosis is a common gynecological disease that mainly influences pelvic organs. However, extra-pelvic endometriosis is considered less prevalent. Here, we present a case study of umbilical endometriosis associated with an underlying hernia. It is known that the incidence of such a case is very rare and its diagnosis is challenging. Surgical excision of this type of lesion with a repair of the hernia is considered the preferred management approach. In this case, a 40-year-old female was admitted to the hospital with cyclical umbilical bleeding for one year. The bleeding would start with her menstruation and continue throughout the menstrual period. Initial diagnosis was made by physical examination and ultrasound imaging. Treatment options were discussed with her and she accepted to undergo surgical wide excision of the umbilical lesion with a repair of the hernia. Diagnosis was further confirmed by a histopathological study of the lesion tissue specimen. Also, a referral to a gynecologist did not report any abnormality or pelvic disease, and the patient was discharged well from the hospital.

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endometriosis

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