Primary Umbilical Endometriosis with Concurrent Paraumbilical Hernia:A Case Report

Ferdousi Begum, Reeva Aireen Busreea, Zaki Ibne Bari, Kamrun Naher, Mohammad Nurunnabi
In: Chattagram Maa-O-Shishu Hospital Medical College Journal · 2026 · vol. 25(2) , pp. 116–119 · doi:10.3329/cmoshmcj.v25i2.94037 · W7225238286
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This case report describes a 27-year-old woman presenting with cyclical umbilical bleeding and pain, which was diagnosed as primary umbilical endometriosis concurrent with a paraumbilical hernia. Diagnostic imaging revealed a mixed echogenic lesion, and normal CA-125 levels did not rule out the condition despite the rarity of extra-pelvic involvement. The patient underwent surgical excision combined with hernioplasty, leading to definitive histopathological confirmation and management of the recurrent symptoms. This paper is centrally about endometriosis — specifically a rare presentation of primary umbilical endometriosis occurring alongside a paraumbilical hernia.

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Abstract

Background: Umbilical endometriosis is a rare form of extra pelvic endometriosis accounting for less than 1% of all endometriosis cases. It commonly presents with cyclical pain, swelling and bleeding from the umbilicus, often leading to delayed diagnosis because of its resemblance to other umbilical pathologies. This report describes a rare case of primary umbilical endometriosis with concurrent paraumbilical hernia, highlighting diagnostic challenges and management considerations. Case Presentation: A 27-year-old multiparous woman presented with a 6-month history of cyclical umbilical bleeding and severe pain associated with menstruation. Physical examination revealed a firm, tender, dark-brown umbilical nodule measuring approximately 2 × 2 cm. Ultrasonography demonstrated a mixed echogenic lesion in the umbilical region suggestive of endometriosis. Laboratory investigations, including serum CA-125, were within normal limits. Based on the clinical and radiological findings, a diagnosis of primary umbilical endometriosis with concurrent paraumbilical hernia was made. The patient was planned for surgical excision with hernioplasty followed by histopathological evaluation. Conclusion: Primary umbilical endometriosis should be considered in reproductive aged women presenting with cyclical umbilical symptoms, particularly bleeding and pain associated with menstruation. Early clinical suspicion and surgical management are essential for definitive diagnosis and prevention of recurrence. Chatt Maa Shi Hosp Med Coll J; Vol.25 (2); July 2026; Page 116-119
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Keywords

Endometriosis; Paraumbilical hernia; Umbilical endometriosis.Abstract

Background

Umbilical endometriosis is a rare form of extra pelvic endometriosis accounting for less than 1% of all endometriosis cases. It commonly presents with cyclical pain, swelling and bleeding from the umbilicus, often leading to delayed diagnosis because of its resemblance to other umbilical pathologies. This report describes a rare case of primary umbilical endometriosis with concurrent paraumbilical hernia, highlighting diagnostic challenges and management considerations. Case Presentation: A 27-year-old multiparous woman presented with a 6-month history of cyclical umbilical bleeding and severe pain associated with menstruation. Physical examination revealed a firm, tender, dark-brown umbilical nodule measuring approximately 2 × 2 cm. Ultrasonography demonstrated a mixed echogenic lesion in the umbilical region suggestive of endometriosis. Laboratory investigations, including serum CA-125, were within normal limits. Based on the clinical and radiological findings, a diagnosis of primary umbilical endometriosis with concurrent paraumbilical hernia was made. The patient was planned for surgical excision with hernioplasty followed by histopathological evaluation. Conclusion: Primary umbilical endometriosis should be considered in reproductive aged women presenting with cyclical umbilical symptoms, particularly bleeding and pain associated with menstruation. Early clinical suspicion and surgical management are essential for definitive diagnosis and prevention of recurrence. Chatt Maa Shi Hosp Med Coll J; Vol.25 (2); July 2026; Page 116-119 12 20 Downloads Published Issue Section License Authors of articles published in CMOSHMC Journal retain the copyright of their articles and are free to reproduce and disseminate their work. A Copyright and License Agreement -signed and dated by the corresponding author on behalf of all authors -must be submitted with each manuscript submission.

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