28321 Cutaneous endometriosis of the umbilicus

Abstract

Cutaneous endometriosis is a rare disorder characterized by the presence of endometrial glands and/or stroma in the skin. Endometriosis most commonly affects pelvic organs in women of reproductive age. Symptoms often include dysmenorrhea and deep pelvic pain but will vary depending on the location. Endometriosis of an extrapelvic site represents less than 1% of all cases of endometriosis. The most common presentation of cutaneous endometriosis is a nodule on the umbilicus, which can be classified as primary or secondary based on the absence or presence of abdominopelvic surgical history, respectively. While a majority of the nodules are benign, there is potential for malignant transformation. In a literature review, 61 cases of primary umbilical endometriosis were found from the period of 2000 to 2020. This case reports on a 42-year-old multiparous woman who presented with a 6-year history of a nodule on the umbilicus measuring 2.2 cm in diameter. She was diagnosed with endometriosis 7 years prior after episodes of dysmenorrhea, and subsequently underwent an endometrial ablation. Both of her children were delivered vaginally, and she had no history of abdominopelvic surgery. She reported that the nodule would swell in a cyclical manner every 3-4 months, associated with intense pain but no bleeding or discharge. Upon histopathologic examination of the nodule, the patient was diagnosed with cutaneous endometriosis. No malignant cells were detected. The nodule was removed by complete excision, and she was referred for gynecological examination.