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Case Reports
. 2023 Jul 25;14(7):20542704231182057.
doi: 10.1177/20542704231182057. eCollection 2023 Jul.

Primary umbilical endometriosis: Surgical case report

Zineb Loudyi  1   2 , S Benammi  1   2 , Y Bakali  1   2 , Hassan Aguouzoul  1   2 , M Alaoui  1   2 , F Sebbah  1   2 , M Raiss  1   2 , A Hrora  1   2
Affiliations
Case Reports

Primary umbilical endometriosis: Surgical case report

Zineb Loudyi et al. JRSM Open. .

Retraction in

Abstract

Introduction: Endometriosis is a benign nevertheless a chronic condition which impacts greatly the quality of life through cyclic discomfort. We aim to report the case of umbilical endometriosis and a literature review of the different treatment modalities.

Case report: This was a case of a 43-year-old woman, with no history, who presented with a painful hemorrhagic umbilical swelling during the menstrual period associated with dysmenorrhea. Abdominal ultrasound revealed a subcutaneous umbilical mass of non-vascularized tissue nature confirmed on Doppler. Pelvic MRI which confirms the diagnosis of primary umbilical endometriosis. The patient underwent wide local excision of the endometriotic nodule with umbilical reconstruction. Histology confirmed the diagnosis of umbilical endometriosis. Resection margins were clear.

Discussion: Extra-pelvic endometriosis sites are not common, especially the umbilicus. It usually occurs secondary to surgical scars, specifically after laparoscopy or open abdominal surgery. Surgical management is currently described as gold standard. Laparoscopic approach is recommended as it allows better visual inspection for secondary localization of endometriosis. Medical management corresponds to combined oral contraceptives (COCs) or progestins for management of endometriotic implants decreasing inflammatory effects, or Gonadotropin-releasing hormone for long-course treatment. Malignant transformation of the umbilical nodule has been described in literature with a reported risk of malignant transformation to be 3%.

Conclusion: Current management of extragenital endometriosis suggest radical surgery with wide local excision. Due to the rarity, there is a paucity of data on umbilical endometriosis and mostly reported from case reports.

Keywords: Other obstetrics and gynaecology; clinical; gastrointestinal surgery; general surgery; obstetrics and gynaecology; surgery.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Clinical view of the endometriotic nodule with umbilical reconstruction.
Figure 2.
Figure 2.
Abdominal mass with iso signal on T1 and high signal on T2, strongly enhanced after injection of contrast product, containing a cystic cell, measuring 35x38 mm on MRI.
See this image and copyright information in PMC

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