Endometriosis of the umbilicus in a 36-year-old woman: a case report and literature review

Abstract

Extrapelvic endometriosis is quite rare, with a reported prevalence ranging between 0.5 and 1%, and the condition is more likely to pose diagnostic challenges. This condition is more likely to pose clinical diagnostic challenges as it may mimic metastasis such as Sister Mary Joseph's nodule.

Case presentation: Herein is reported the case of a 36-year-old woman who presented with a hard nodular dark-bluish umbilicus mass that had a tendency to increase in size and was accompanied by severe pain during menstruation for ∼2 years is reported. Laparotomy revealed a normal uterus without involvement of any other pelvic organ by the endometrial tissue except the umbilicus part. Histological evaluation revealed endometriosis of the umbilicus.

Clinical discussion: By far, primary endometriosis of the umbilicus is extremely rare, and most of the time, extrapelvic endometriosis involving the umbilicus would be secondary to surgical procedures involving the abdominal cavity as it was for the presented patient. Although endometriosis is rare, it should always be considered among women of reproductive age presenting with cyclic pains.

Conclusions: Meticulous investigation of patients suspected to have umbilical endometriosis helps to confirm the diagnosis and hence expedites proper management of the patients; this also prevents chances of malignant transformation of the condition despite such possibilities being extremely rare.

Keywords: endometriosis; extrapelvic endometriosis; umbilicus.

Figure 1

Umbilical lump with bluish discoloration.

Figure 2

Papanicolaou stain showing epithelial cells without atypia which resembles endometrial origin with hemorrhage (×400).

Figure 3

Haematoxylin and eosin section showing tortuous glands surrounded by dense cellular stroma lying in a collagenous background (×100).