Primary Umbilical Endometriosis: A Systematic Literature Review

Abstract

Study Objective To determine the characteristics of primary umbilical endometriosis. Design Systematic literature review from 2007-2020. Setting N/A. Patients or Participants Literature was reviewed via PubMed, EMBASE, and Web of Science for case reports of primary umbilical endometriosis using search terms “umbilical” and “endometriosis: from 2007-2020. Results were limited to articles published in English. Interventions No intervention was performed. Measurements and Main Results Three hundred and fifty-two articles were returned. Ninety-three case reports met inclusion criteria and 104 individual patient cases of primary umbilical endometriosis were identified. The mean age of presentation was 36.8 (±7.8) and the majority were nulliparous (55% vs 45%). he time to presentation from first symptoms varied widely from 3 days to 240 months with an average of 12 months. There were 8 patient who presented from 120-240 months. Forty three percent of patients reported dysmenorrhea and 26% reported pelvic pain. Sixty one percent had previously used hormonal contraception. Mass characteristics are presented in table 2. Ninety seven percent presented with a mass, 86 percent with pain, and 64% with bleeding or discharge. Color was variable with 38% brown, 24% red, 13% blue, 10% normal skin tone, 8% black, and 7% purple. Discharge was present in 62% with 60% of the cohort having bleeding. On average, lesions were 1-1.5cm and 61% invaded the umbilical fascia. Correlations between age, time to presentation, mass size, and presence of bleeding were evaluated. Time to presentation and mass dimension 1 were positively correlated (N=96, Spearman correlation coefficient=0.16, p=0.128) as were age and mass dimension 2 (N=42, Spearman correlation coefficient=0.29, p=0.059). Conclusion Primary umbilical endometriosis is not uncommon. There are no significant correlations between age, time to presentation, mass size and bleeding. Primary umbilical endometriosis should be in the differential diagnosis of patients presenting with umbilical pain, mass, or bleeding. To determine the characteristics of primary umbilical endometriosis. Systematic literature review from 2007-2020. N/A. Literature was reviewed via PubMed, EMBASE, and Web of Science for case reports of primary umbilical endometriosis using search terms “umbilical” and “endometriosis: from 2007-2020. Results were limited to articles published in English. No intervention was performed. Three hundred and fifty-two articles were returned. Ninety-three case reports met inclusion criteria and 104 individual patient cases of primary umbilical endometriosis were identified. The mean age of presentation was 36.8 (±7.8) and the majority were nulliparous (55% vs 45%). he time to presentation from first symptoms varied widely from 3 days to 240 months with an average of 12 months. There were 8 patient who presented from 120-240 months. Forty three percent of patients reported dysmenorrhea and 26% reported pelvic pain. Sixty one percent had previously used hormonal contraception. Mass characteristics are presented in table 2. Ninety seven percent presented with a mass, 86 percent with pain, and 64% with bleeding or discharge. Color was variable with 38% brown, 24% red, 13% blue, 10% normal skin tone, 8% black, and 7% purple. Discharge was present in 62% with 60% of the cohort having bleeding. On average, lesions were 1-1.5cm and 61% invaded the umbilical fascia. Correlations between age, time to presentation, mass size, and presence of bleeding were evaluated. Time to presentation and mass dimension 1 were positively correlated (N=96, Spearman correlation coefficient=0.16, p=0.128) as were age and mass dimension 2 (N=42, Spearman correlation coefficient=0.29, p=0.059). Primary umbilical endometriosis is not uncommon. There are no significant correlations between age, time to presentation, mass size and bleeding. Primary umbilical endometriosis should be in the differential diagnosis of patients presenting with umbilical pain, mass, or bleeding.