Primary Umbilical Endometriosis: A Case Report and Literature Review

Sintayehu Asrat Beyene,1 Nahom Tadesse Bogale,1 Binyam Mohammedbirhan Berhe,2 Demis Degu Teshome3 1General Surgery Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia; 2Department of Pathology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia; 3Department of Obstetrics and Gynecology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, EthiopiaCorrespondence: Sintayehu Asrat Beyene; Nahom Tadesse Bogale, Email sintayehubeyene54@gmail.com; Tadnahi2@gmail.comIntroduction: Endometriosis is a disease condition characterized by the presence of endometrial glands and stroma outside the uterine cavity and musculature. It affects 7– 10% of women of reproductive age and usually involves pelvic organs. The common symptoms include dysmenorrhea, menorrhagia, pelvic pain, dyspareunia, and infertility. Umbilical endometriosis is the rarest form of extra-pelvic endometriosis.Case Presentation: A 32-year-old Para II mother presented with umbilical swelling and pain that worsened during the menses of 2 months. She had two caesarean scars, both transverse Pfannenstein incisions. There was a dark blue, firm to hard 2× 3 cm umbilical mass on physical examination. Laboratory results are normal. Ultrasound of the abdomen showed umbilical mass with homogeneous echotexture measuring 2 cm × 3 cm with an irregular border and hypoechoic texture. An excisional biopsy was performed and a biopsy showed umbilical endometriosis.Discussion: Primary umbilical endometriosis is a disorder first described by Villar in 1886, and among all cases of extra-genital involvement of endometriosis, primary umbilical endometriosis accounts for 0.5– 1%. The usual presentation of primary umbilical endometriosis is typically the presence of a discrete bluish-purple mass in the umbilicus, which becomes swollen, painful, and bleeds concomitantly with the menstrual cycle. Ultrasound and other imaging techniques help in making diagnoses, and the diagnosis is confirmed by cytological examination. The management of umbilical endometriosis involves surgical excision and reconstruction of the umbilicus.Conclusion: Umbilical endometriosis is an uncommon form of extra-pelvic endometriosis. There is a wide differential diagnosis for swellings of the abdominal wall; however, it should be suspected in any female patient of reproductive age with an umbilical lesion that becom