Menstruating umbilicus! A rare case report of primary umbilical endometriosis with review of literature

Renuka Malik, Preeti Sharma
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2016 · pp. 2453–2456 · doi:10.18203/2320-1770.ijrcog20162149 · W2465021680
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report details a primary umbilical endometriosis diagnosis in a patient with a painful, bleeding umbilical nodule, subsequently treated with local excision and reconstruction.

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This paper is a case report and literature review of primary umbilical endometriosis, focusing on a patient with an umbilical nodule that had been enlarging for 6 months and became painful and bled during menses, with no prior gynecologic surgery. Imaging including MRI led to a provisional diagnosis, and diagnostic laparoscopy was performed to rule out concomitant pelvic endometriosis before wide local excision and umbilical reconstruction. The authors report that primary umbilical endometriosis is rare and note that medical treatment is described as palliative rather than definitive for this condition, with the aim of avoiding recurrence through correct management, though the main limitation is that this is based on a single case. This paper is centrally about endometriosis — specifically primary umbilical endometriosis presenting as a menstruating umbilical nodule without prior surgery.

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Abstract

Umbilical endometriosis (UE) represents 0.5% to 1% of all cases of extra genital endometriosis. Primary umbilical endometriosis is the presence of ectopic endometrial tissue located in the umbilicus in absence of previous surgery for either gynecological disorders or cesarean section which is defined as secondary umbilical endometriosis. Secondary UE, which is more common than primary UE and is probably due to the iatrogenic dissemination and implant of endometrial cells during either laparoscopic or open surgical procedures. Mrs. X, presented in OPD with an umbilical nodule since 6 months which grew in size and became painful and bled during periods. Imaging studies were done including MRI. A provisional diagnosis of umbilical endometriosis was made as patient had no history of any prior surgery. Patient had no suggestive history of pelvic endometriosis. Diagnostic laparoscopy was done to rule out concomitant pelvic endometriosis followed by wide local excision and umbilical reconstruction was done. By plastic surgeons. Knowledge of this rare condition and correct management is important to avoid recurrence. Medical treatment is only palliative not definitive in this condition.
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Menstruating umbilicus! A rare case report of primary umbilical endometriosis with review of literature DOI: https://doi.org/10.18203/2320-1770.ijrcog20162149Keywords: Umbilical nodule, Extra pelvic endometriosis, Primary umblical endometriosisAbstract Umbilical endometriosis (UE) represents 0.5% to 1% of all cases of extra genital endometriosis. Primary umbilical endometriosis is the presence of ectopic endometrial tissue located in the umbilicus in absence of previous surgery for either gynecological disorders or cesarean section which is defined as secondary umbilical endometriosis. Secondary UE, which is more common than primary UE and is probably due to the iatrogenic dissemination and implant of endometrial cells during either laparoscopic or open surgical procedures. Mrs. X, presented in OPD with an umbilical nodule since 6 months which grew in size and became painful and bled during periods. Imaging studies were done including MRI. A provisional diagnosis of umbilical endometriosis was made as patient had no history of any prior surgery. Patient had no suggestive history of pelvic endometriosis. Diagnostic laparoscopy was done to rule out concomitant pelvic endometriosis followed by wide local excision and umbilical reconstruction was done. By plastic surgeons. Knowledge of this rare condition and correct management is important to avoid recurrence. Medical treatment is only palliative not definitive in this condition.Metrics References Fancellu A, Pinna A, Manca A, Capobianco G, Porcua A. Primary umbilical endometriosis. Case report and discussion on management options. Int J Surg Case Rep. 2013;4(12):1145-8. Mizutani T, Sakamoto Y, Ochiai H, Maeshima A. umbilical endometriosis with urachal remnant. Arch Dermatol. 2012;148(11):1331-2. Calagna G, Perino A, Chianetta D, Vinti D, Triolo MM, Rimi C, et al. Primary umbilical endometrioma: analyzing the pathogenesis of endometriosis from an unusual localization. Taiwanese Journal of Obstetrics and Gynecology. 2015;54(3):306-12. Pallavi VB, Giurguis MM. Menstruating from the umbilicus as a rare case of primary umbilical endometriosis: a case report. J Med Case Rep. 2009;3:9326. Efremidou EI, Kouklakis G, Mitrakas A, Liratzopoulos N, Polychronidis ACH. Primary umblical endometrioma: a rare cause of spontaneous abdominal wall endometriosis. Int J Gen Med. 2012;5:999-1002. Victory R, Diamond MP, Johns DA. Villar's nodule: a case report and systematic literature review of endometriosis external of the umbilicus. J Minim Invasive Gynecol. 2007;14:23-32. Obata K, Ikoma N, Oomura G, Inoue Y. Clear cell adenocarcinoma arising from umbilical endometriosis. Journal of Obstetrics and Gynaecology Research. 2013;39:455-61. Fedele L, Frontino G, Bianchi S, Borruto F, Ciappina N. Umbilical endometriosis: a radical excision with laparoscopic assistance. Int J Surg. 2010;8(2):109-11.

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