Menstruating umbilicus - secondary subcutaneous umbilical endometriosis: a rare case report

This paper describes a rare case of secondary umbilical endometriosis in a young nulliparous female and its effective diagnosis and treatment. A 29-year-old unmarried female presented with complaints of bleeding during menses from an umbilical nodule that had developed at the port insertion site of a previous diagnostic hystero-laparoscopy. Ultrasound and Doppler examinations confirmed the presence of a hypoechoic mass in the umbilicus with no associated blood vessels. Deep surgical excision of the nodule with a rim of macroscopic normal skin of 0.5 cm all around was performed under local anesthesia and the umbilicus was reconstructed. This case reinforces the concept that umbilical endometriosis should be considered in the list of differential diagnoses of umbilical disorders, even in young nulliparous women with no typical symptoms of pelvic endometriosis. Additionally, it emphasizes the importance of early diagnosis of UE in order to avoid extensive abdominal wall surgery.