Primary Umbilical Endometriosis Research Articles

Retracted: “Primary umbilical endometriosis: Surgical case report”

Retracted: “Primary umbilical endometriosis: Surgical case report”

Spontaneous Umbilical Endometriosis: Case Report of a Cyclical Painful Umbilical Swelling

Primary or spontaneous umbilical endometriosis is the presence of ectopic endometrial tissue in the umbilicus in the absence of previous surgery. It is a rare entity but should be considered as a possible differential diagnosis in cases of umbilical disorders even if the patient has no typical symptoms of pelvic endometriosis.

Primary Umbilical Endometriosis: A Rare Entity

Primary umbilical endometriosis is a rare benign gynaecological disorder caused by ectopic endometrial tissue in the umbilicus. The disease typically manifests as a painful umbilical nodule associated with cyclic bleeding or discharge during menstruation. Here, a 46-year-old woman with low parity and without previous history of abdominal surgery has been reported who presented with cyclical per-umbilical bleeding and pain in the umbilical region during menstruation without any palpable umbilical nodule. The patient responded well to initial medical management, but symptoms recurred on discontinuation of the medication. Though clinically, there was no palpable nodule, and ultrasonography revealed a hypoechoic lesion in the lower umbilical region suggestive of endometrial deposition. On resuming medical management, her symptoms abated. J Bangladesh Coll Phys Surg 2023; 41: 173-176

Primary Umbilical Endometriosis: Case Report

Endometriosis is a benign condition that occurs during the productive age in women However, one of the rare disorders of endometriosis location-wise is the umbilical endometriosis. Umbilical endometriosis had been into divided primary and secondary umbilical endometriosis depending on the causes; either after laparoscopic or open procedures which are secondary. The primary happened unexpectedly. MRI sensitivity is superior to detecting small lesions. According to a study done in 2002, MRI sensitivity and specificity to detect biopsy-was proven 69% and 75%. In this case report, the patient was a 38-year-old single girl with primary umbilical endometriosis. For treatment, most cases with umbilical endometriosis have been treated with surgery. However, treatment with medication needs to be researched and requires more investigation.

Management options for primary umbilical endometriosis: a case report

Background: The common location of Endometriosis is in genitalia organs, for instance, the ovary, uterus, fallopian tube, and sometimes even in the intestine, bladder, and in rare locations such as the navel, lungs, or brain. Umbilical Endometriosis is the most irregular form of Endometriosis and the most common cutaneous form of Endometriosis. Primary umbilical endometriosis diagnosis is often biased and delayed; the exact etiopathology remains unclear. Our case report discusses the diagnosis and management options for this rare disease. Case presentation: We reported a Primary Umbilical Endometriosis case, confirmed by a history of the nodule with pain, swelling, and bleeding at the umbilicus, which occurs during menstruation. The nodule was surgically removed, and histopathological analysis shows fibromycsoid tissue with multiple forms of subepithelial endometrial glands and surrounding stroma, confirmed as Endometriosis. Conclusion: The definitive treatment for umbilical Endometriosis is surgical excision with total removal of the umbilicus. The prognosis is good, and the recurrence rate is meager if complete excision is successfully performed.

8969 Excision of Primary Umbilical Endometriosis Under Local Anesthesia

<h3>Study Objective</h3> To excise primary umbilical endometriosis using local anesthesia, thereby reducing demand for operating room resources during the COVID-19 pandemic. <h3>Design</h3> Case study of two cases of primary umbilical endometriosis, excised under local anesthesia. <h3>Setting</h3> Outpatient clinic with procedure room. <h3>Patients or Participants</h3> Two patients referred to gynecology for isolated umbilical endometriosis. <h3>Interventions</h3> Excision of primary umbilical endometriosis in the outpatient clinic under local anesthesia. <h3>Measurements and Main Results</h3> Patients were assessed for adequate excision immediately at the end of the procedure and one was re-assessed at two months post-procedure. <h3>Conclusion</h3> Excision of primary umbilical endometriosis can be adequately performed in the out-patient setting under local anesthesia, further reducing demand for operative time during the COVID-19 pandemic.

PRIMARY UMBILICAL ENDOMETRIOSIS: A RARE CASE REPORT

Umbilical endometriosis is a rarest form of extrapelvic endometriosis, incidence being 0.5% - 1% of all extrapelvic endometriosis. In primary umbilical endometriosis there is no history of any previous abdominal and pelvic invasive procedures. Most patients present with an umbilical nodule which is associated with cyclical pain and bleeding from the lesion during menstrual cycle. It is mainly diagnosed clinically and is conrmed by histopathology. Surgery is the treatment of choice. Pre and post operative hormonal supplementation results in better outcome

Primary Umbilical Endometriosis (Villar’s Nodule): A Rare Symptomatic Umbilical Pathology in An Adult Woman

A 35-year old married non-diabetic, non-hypertensive, non-alcoholic, non-smoking and non-betel-nut-chewing poor housewife having average body build and body weight hailing from Shahjadpur of Sirajgonj district got herself admitted with intermittent pain and 2.5x1.75 cm sized discolored swelling in the umbilical region for one year. The dull aching non-radiating pain aggravated by moving was not associated with fever, chills and rigor. The pain was distinctly remarkable during regular normal menstrual flow. It was responding variably to traditional analgesic and nonspecific antimicrobial drugs as advised by local village doctors. But she was not cured. Her bowel and bladder habits were normal. She had no abdominal pain, distension, chest pain, bone pain, dyspnea, cough, jaundice, umbilical discharge of faeces, blood or urine. Her two children were born normally (i.e., by NVD: Normal Vaginal Delivery). She had no previous history of any form of surgery. Her rt-PCR for Covid-19 test was negative with normal liver and kidney function tests and normal sonographic findings of the whole abdomen. Our clinical diagnosis of primary umbilical endometriosis was supported by FNAC from discolored umbilical swelling. After having an informed written consent we excised the umbilicus. The histopathological report had confirmed our preoperative diagnosis. The post-operative period was smooth and uneventful. We like to share our experience of diagnosing and treating this very rare disease of primary umbilical endometriosis. KYAMC Journal Vol. 13, No. 01, April 2022: 56-60

Primary Umbilical endometriosis - case series and review of clinical presentation, diagnosis and management.

IntroductionUmbilical endometriosis is the most common cutaneous form and is seen mostly secondary to surgical scar and rarely occurs as primary umbilical endometriosis. The objective of this retrospective case series evaluation is to report the presentation, diagnosis, and management of patients with primary umbilical endometriosis.Presentation of casesWe present a retrospective, observational and descriptive review of cases presenting with primary umbilical endometriosis among Indian women managed in two private tertiary care centres between 2018 and 2020. Patients were assessed at the gynaecological outpatient department. We analysed age, parity, presenting symptoms and duration, associated symptoms, imaging, size of the lesion, associated pelvic endometriosis or any pelvic pathology, management, and histopathological diagnosis for confirmation in all four patients.DiscussionThe patients were aged between 25 and 31 years with an average of 28 years with no previous history of any abdominal surgeries. The mean duration of the symptoms presented in these cases was 25.5 months, with a range from 18 to 48 months. The diagnosis was made by clinical examination supported by imaging followed by complete surgical excision and confirmation on histopathology.ConclusionPrimary umbilical endometriosis is a rare disease with a limited number of cases reported in the literature and should be included in the differential diagnosis if women present with umbilical lesions with cyclical pain. Diagnosis is clinical but can be aided by high resolution imaging such as Ultrasound (US) and Magnetic Resonance Imaging (MRI). Complete surgical excision is the treatment of choice.

Primary umbilical endometriosis coexisiting with multiple uterine fibroids: A case report.

IntroductionUterine fibroids and endometriosis are independent causes of infertility/subfertility in women of reproductive age. Primary umbilical endometriosis is rare.Presentation of caseHere, we report a case of primary umbilical endometriosis coexisting with multiple uterine fibroids in a 35 year old nulliparous woman who presented with abdominal swelling as well as cyclical pain and swelling of the umbilicus without any previous surgery. She had abdominal myomectomy and excision of the umbilical lesion with histological confirmation of uterine fibroids and umbilical and peri-umbilical endometriosis.DiscussionPrimary umbilical endometriosis should be considered as a possible differential diagnosis in cases of umbilical disorders even if the patient has no typical symptoms of pelvic endometriosis. The clinical features include an umbilical swelling (90%), often associated with cyclical pain (81.5%) and bleeding or discharge (49.2%); while some patients may be asymptomatic. The diagnosis of umbilical endometriosis could be made based on clinical findings but histological confirmation is the gold standard for diagnosis. The definitive treatment for umbilical endometriosis is surgical excision.ConclusionAlthough rare, primary umbilical endometriosis may coexist with uterine fibroids and should be suspected in women of reproductive age who complain of cyclical umbilical disorders in addition to abdominal swelling or other symptoms of uterine fibroids.

Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal.

Umbilical endometriosis represents 30–40% of abdominal wall endometriosis and around 0.5–1.0% of all cases of endometriosis. The aim of this systematic review is to revisit the epidemiology, signs, and symptoms and to formulate a pathogenic theory based on literature data. We performed a systematic literature review using the PubMed and Embase databases from 1 January 1950 to 7 February 2021, according to the PRISMA guidelines. The review was registered at PROSPERO (CRD42021239670). Studies were selected if they reported original data on umbilical endometriosis nodule defined at histopathological examination and described as the presence of endometrial glands and/or stromal cells in the connective tissue. A total of 11 studies (10 retrospective and one prospective), and 14 case series were included in the present review. Overall, 232 umbilical endometriosis cases were reported, with the number per study ranging from 1 to 96. Umbilical endometriosis was observed in 76 (20.9%; 95% CI 17.1–25.4) of the women included in studies reporting information on the total number of cases of abdominal wall endometriosis. Umbilical endometriosis was considered a primary form in 68.4% (158/231, 95% CI 62.1–74.1) of cases. A history of endometriosis and previous abdominal surgery were reported in 37.9% (25/66, 95% CI 27.2–49.9) and 31.0% (72/232, 95% CI 25.4–37.3) of cases, respectively. Pain was described in 83% of the women (137/165, 95% CI 76.6–88.0), followed by catamenial symptoms in 83.5% (142/170, 95% CI, 77.2–88.4) and bleeding in 50.9% (89/175, 95% CI 43.5–58.2). In the 148 women followed for a period ranging from three to 92.5 months, seven (4.7%, 95% CI 2.3–9.4) recurrences were observed. The results of this analysis show that umbilical endometriosis represents about 20% of all the abdominal wall endometriotic lesions and that over two thirds of cases are primary umbilical endometriosis forms. Pain and catamenial symptoms are the most common complaints that suggest the diagnosis. Primary umbilical endometriosis may originate from implantation of regurgitated endometrial cells conveyed by the clockwise peritoneal circulation up to the right hemidiaphragm and funneled toward the umbilicus by the falciform and round liver ligaments.

Umbilical Hernia as Forerunner of Primary Umbilical Endometriosis: A Case Report.

Umbilical endometriosis is a type of cutaneous endometriosis that usually follows laparoscopic or surgical procedures that involve the umbilicus. Primary umbilical endometriosis (PUE) is an extremely rare condition and its association with an umbilical hernia is an equally rare condition. To date, only very few cases of PUE with umbilical hernia association have been reported in the medical literature. Report herein is a case of PUE associated with an umbilical hernia who presented with classical umbilical nodule symptoms with cyclical pain and bleeding due to menstruation. The patient underwent omphalectomy with abdominal wall defect repair using prosthetic mesh. The diagnosis was confirmed by histopathological examination of the excised umbilical nodule. This case report highlights a rare entity that should be considered as a differential diagnosis in females of the reproductive age group that presents with the umbilical nodule.

Primary Umbilical Endometriotic Nodule with an Ultrasound Incidental Finding of Ovarian Endometrioma and a Solitary Intramural Uterine Myoma: A Case Report

Endometriosis is the presence of endometrial stroma outside the uterine cavity. Endometrioma (chocolate cyst) is the most common form of endometriosis. Primary umbilical endometriosis (PUE) is rare, with a prevalence of < 1% of endometriosis cases. Our case is a 25-year-old nulliparous female with a three-year history of infertility presenting with primary umbilical endometriosis and an abdomino-pelvic ultrasonography finding of a right endometrioma, and a solitary intramural uterine myoma. These three findings in a patient are a rare occurrence. Abdominopelvic ultrasound and excision biopsy was performed to arrive at a diagnosis.

Primary Umbilical Endometriosis: A Systematic Literature Review

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.

Primary umbilical endometriosis – A rare presentation of cutaneous endometriosis

Primary umbilical endometriosis is a rare condition with an overall incidence of around 0.5% to 1% among all the endometriosis cases, but at times it poses a diagnostic dilemma. In our institution we encountered a case of primary umbilical endometriosis presented to multiple surgical speciality departments. A prompt clinical examination with surgical biopsy was the key tool which lead to the diagnosis and providing a complete cure for the patient. Pelvic endometriosis affects 5-10% of women in the child bearing age group. The most pronounced symptoms are dyspareunia, pelvic pain, and infertility. Clinical presentations of umbilical endometriosis are as a nodule with or without associated umbilical pain and bleeding. This patient was given primary hormonal therapy and later underwent a biopsy which paved way for an accurate diagnosis of primary umbilical endometriosis. In this case of umbilical swelling, conditions like a benign nevus, lipoma, abscess, cyst, hernia, as well as metastatic deposit from a systemic malignancy were considered in the clinical differential diagnosis. However surgical excision helped us arrive at a definitive diagnosis and cure for the patient.

28321 Cutaneous endometriosis of the umbilicus

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.

Primary umbilical endometriosis: Radical excision (omphalectomy) and laparoscopic management of associated pelvic endometriosis in a low resource tertiary hospital.

Primary umbilical endometriosis (PUE) is a rare condition affecting 0.5 - 1% of all extragenital endometriosis cases. We reviewed the data of five women with umbilical endometriosis retrospectively. The age range was 29 - 46 years, and they were all nulligravid at presentation. Common clinical presentation was umbilical pain and masses, dysmenorrhea, and primary infertility. Radical umbilical excision was performed to remove the nodule as a definitive treatment. Diagnostic laparoscopy was performed, followed by varying degrees of operative laparoscopic procedures. They all had endometriosis in the pelvis. Three out of five women operated became pregnant and had live births. Complete resolution of clinical symptoms with a reduction in umbilical and menstrual pain scores occurred. In resource-constrained settings, diagnosis, and treatment of PUE may be challenging. Clinical suspicion and appropriate case management are critical for good reproductive outcomes and quality of life.

Painless umbilical nodule in a nulliparous female – A clinical quandary

Background: Endometriosis is a well-known entity most often found within the pelvis and extra pelvic sites like skin, diaphragm, gastrointestinal tract and brain. Primary umbilical endometriosis is a rare form of cutaneous endometriosis, typically presenting as a hyperpigmented umbilical nodule with or without cyclical pain. We present a case of painless umbilical nodule with discolouration in a nulliparous woman, unsuspected clinically with the diagnosis being made primarily on cytology. Case report: A forty-year old female presented with a painless, brownish discoloured umbilical nodule, which was present since two months, was irreducible and had a negative cough impulse. She had no prior surgeries. Ultrasonography of abdomen and pelvis revealed a hypodense lesion of 2cm in the umbilicus, suggesting a possibility of umbilical granuloma. Uterus showed leiomyomata. Cytological evaluation of the umbilical nodule was suggestive of endometriosis. The patient underwent hysterectomy for leiomyomata and omphalectomy. Histopathology confirmed the diagnosis of umbilical endometriosis supported by the immunohistochemistry marker (CD10) being positive for endometrial stromal cells. The uterus had adenomyotic foci in addition to leiomyomata. Conclusion: The clinical distinction between primary umbilical endometriosis and other causes of umbilical nodules is challenging. Imaging modalities do not show pathognomonic signs in establishing this diagnosis. A definitive diagnosis is possible on cytology based on classical morphological features with histopathological examination being the gold standard diagnostic modality.

Rare clinical presentation of umbilical endometriosis

Primary umbilical endometriosis is a rare disorder accounting for 0.5%–1% of extragenital endometriosis. It is defined as the presence of ectopic endometrial tissue within the umbilicus. Although it mostly presents as a typical cyclic umbilical discharge coincidental with a palpable mass, the diagnosis is often delayed due to its low prevalence and abnormal presentation, as in this case. The possibility of subcutaneous endometriosis should not be ruled out when an umbilical mass is detected, even if there is no history of previous surgery. Other differential diagnoses of umbilical mass include paraumbilical hernia, surgical scar (laparoscopy), primary umbilical tumor, granuloma, Sister Mary Joseph's nodule, and urachal duct cyst. In our report, we present the case of a 40-year-old female who came with a painless mass in the umbilicus for the past 10 years.

“Umbilical mass”: a case of primary umbilical endometriosis and literature review

“Umbilical mass”: a case of primary umbilical endometriosis and literature review