Primary Cutaneous Endometriosis of the Umbilicus

Primary Cutaneous Endometriosis of the Umbilicus 1 Image Description A 42-year-old woman with no history of abdominal surgery presented with a gradually enlarging umbilical lesion over three years, associated with recurrent bleeding during menstruation. Examination revealed a firm and multilobulated 2.5-cm nodule (Figure 1). A skin biopsy showed dermal infiltration by glandular structures lined by columnar epithelium, embedded in fibrotic stroma with focal hemorrhage and calcification—findings consistent with cutaneous endometriosis. Pelvic MRI revealed an additional 1.5-cm lesion on the posterolateral aspect of the uterus, suggestive of pelvic endometriosis. Umbilical endometriosis (UE) is a rare form of extragenital endometriosis, accounting for less than 1% of all cases [1]. It primarily affects women of reproductive age and may be classified as either primary (Villar's nodule) or secondary (in the context of abdominal surgery) [1, 2]. Clinically, umbilical endometriosis often presents as a tender, violaceous nodule that bleeds in synchrony with menstruation [1, 3]. Wide local excision with negative margins is the preferred treatment, but hormonal therapy (e.g., GnRH analogs or oral contraceptives) may be employed to suppress ectopic endometrial activity in selected cases [1, 3]. In this case, complete surgical excision was performed, and no evidence of recurrence was observed after 3 months of follow-up. Consent Informed consent was obtained in accordance with current ethical standards. Conflicts of Interest The authors declare no conflicts of interest. Data Availability Statement The data that support the findings of this study are available from the corresponding author upon reasonable request.