Primary Umbilical Endometriosis in a 52-Year-Old Woman: A Case Report

Authors

  • Ismu Nugroho University of Airlangga

DOI:

https://doi.org/10.55927/fjst.v5i4.53

Keywords:

Umbilical Endometriosis, Villar's Nodules, Umbilical Mass, Extensive Excision, Case Reports.

Abstract

Primary umbilical endometriosis is an exceptionally rare extragenital manifestation often misdiagnosed due to its clinical similarity to other umbilical masses, especially in patients without prior pelvic surgery. This study aims to analyze the diagnostic process and surgical intervention effectiveness in a perimenopausal patient. A qualitative descriptive case study was conducted on a 52-year-old woman selected via purposive sampling. Data were gathered through longitudinal clinical documentation, including medical history, physical examination, and radiological evaluations (ultrasound and CT scans), confirmed by histopathological reports. Results identified a 3.16 × 3.37 × 2.8 cm hypoechoic solid mass with peripheral vascularization and increased post-contrast density, manifesting as cyclic bleeding. Management through wide excision successfully achieved total removal, with histopathology confirming umbilical endometriosis and no recurrence during a one-year follow-up. This study concludes that primary umbilical endometriosis should be a primary differential diagnosis for umbilical masses presenting with cyclic bleeding. Its practical contribution emphasizes integrating imaging with histopathological confirmation as the gold standard, highlighting wide excision as a definitive therapeutic modality for optimal clinical outcomes and prevention of recurrence

References

Al Wattar, B. H., Fisher, M., Bevington, L., Talaulikar, V., Davies, M., Conway, G., & Yasmin, E. (2021). Clinical practice guidelines on the diagnosis and management of polycystic ovary syndrome: A systematic review and quality assessment study. Journal of Clinical Endocrinology and Metabolism, 106(8), 2436–2446. https://doi.org/10.1210/clinem/dgab232

Ashindoitiang, J. A., Nwagbara, V. I. C., Ugbem, T. I., Ukam, J. S., & Asuquo, M. E. (2024). Umbilical nodule, a rare presentation of primary cutaneous endometriosis: Case report and literature review. Rare Tumors, 16. https://doi.org/10.1177/20363613241285148

Bala, M., Catena, F., Kashuk, J., De Simone, B., Gomes, C. A., Weber, D., Sartelli, M., Coccolini, F., Kluger, Y., Abu-Zidan, F. M., Picetti, E., Ansaloni, L., Augustin, G., Biffl, W. L., Ceresoli, M., Chiara, O., Chiarugi, M., Coimbra, R., Cui, Y., … Moore, E. E. (2022). Acute mesenteric ischemia: Updated guidelines of the World Society of Emergency Surgery. World Journal of Emergency Surgery, 17(1), 37. https://doi.org/10.1186/s13017-022-00443-x

Cain, N., Bahrami, S., Masamed, R., Dave, H., & Patel, M. (2021). The implants no woman wants: A multimodality review of endometriosis. Current Problems in Diagnostic Radiology, 50(6), 848–858. https://doi.org/10.1067/j.cpradiol.2021.06.002

Duralde, E. R., Sobel, T. H., & Manson, J. E. (2023). Management of perimenopausal and menopausal symptoms. BMJ, 382, e072612. https://doi.org/10.1136/bmj-2022-072612

Ha, D. L., Yang, M. Y., Shin, J. O., Kim, H. S., Ko, H. C., Kim, B. S., & Kim, M. B. (2021). Benign umbilical tumors resembling Sister Mary Joseph nodule. Clinical Medicine Insights: Oncology, 15. https://doi.org/10.1177/1179554921995022

Hirata, T., Koga, K., & Osuga, Y. (2020). Extra-pelvic endometriosis: A review. Reproductive Medicine and Biology, 19(4), 323–333. https://doi.org/10.1002/rmb2.12340

Hordiychuk, A., & Mehanna, D. (2022). Spontaneous rupture of splenic artery pseudoaneurysm. Journal of Surgical Case Reports, 2022(12), rjac604. https://doi.org/10.1093/jscr/rjac604

Lukac, S., Schmid, M., Pfister, K., Janni, W., Schäffler, H., & Dayan, D. (2022). Extragenital endometriosis in the differential diagnosis of non-gynecological diseases. Deutsches Ärzteblatt International, 119(20), 361–367. https://doi.org/10.3238/arztebl.m2022.0176

Martinelli, C., Vidali, A., Di Chiara, F., Mazzarotti, G., El Messaoudi, S., Alfano, L., Ercoli, A., & Giordano, A. (2025). Endometriosis: A cancer-mimicking disease and the need for a translational perspective. Annals of Research in Oncology, 5(2), 75–88. https://doi.org/10.48286/aro.2025.107

Montagna, D., & Ruggiero, R. (2023). The common origin of multicellularity and cancer: Lessons from the fossil record perspectives and hypotheses. Organisms: Journal of Biological Sciences, 6(2), 43–69. https://doi.org/10.13133/2532-5876/18130

Msc, A. (2022). Laparoscopy and endometriosis. [Research Report/Thesis]. https://doi.org/10.13140/RG.2.2.33842.02241

Obrycka, P., Soczynska, J., Gawelczyk, W., Tomecka, P., & Mozdziak, P. E. (2024). Endometriosis – Hormones and treatment. Medical Journal of Cell Biology, 12(2), 54–60. https://doi.org/10.2478/acb-2024-0008

Sacchetti, F., Alsina, A. C., Morganti, R., Innocenti, M., Andreani, L., Muratori, F., Scoccianti, G., Totti, F., Campanacci, D. A., & Capanna, R. (2021). Re-excision after unplanned excision of soft tissue sarcoma: A systematic review and metanalysis. Journal of Orthopaedics, 25, 244–251. https://doi.org/10.1016/j.jor.2021.05.022

Sagay, I., Taiwo, A. E., Bolarinwa, T., Akomolafe, O. O., & Oparah, S. (2022). Enhancing diagnostic accuracy and treatment planning through advanced image analysis. International Journal of Multidisciplinary Research and Growth Evaluation, 3(3), 692–698. https://doi.org/10.54660/.ijmrge.2022.3.3.692-698

Schmidt, V. F., Masthoff, M., Czihal, M., Cucuruz, B., Häberle, B., Brill, R., Wohlgemuth, W. A., & Wildgruber, M. (2021). Imaging of peripheral vascular malformations — Current concepts and future perspectives. Molecular and Cellular Pediatrics, 8(1), 1. https://doi.org/10.1186/s40348-021-00132-w

Siva Achanna, K., & Nanda, J. (2022). Evaluation and management of abnormal uterine bleeding. Journal of South Asian Federation of Obstetrics and Gynaecology, 14(3), 324–330. https://doi.org/10.5005/jp-journals-10006-2065

Soo, T. H., Ganapragasam, M., Suppiah, S., & Bahari, N. (2024). Evaluating umbilical masses: Lessons learned from three elderly patients. Cureus, 16(9), e67667. https://doi.org/10.7759/cureus.67667

Sun, Q., Tang, L., & Zhang, D. (2023). Molecular mechanisms of uterine incision healing and scar formation. European Journal of Medical Research, 28(1), 485. https://doi.org/10.1186/s40001-023-01485-w

Tariq, M. D., Hamza, H. M., Ahsan, A., Sarfraz, T., Malik, M. M., Aneeqa, S., Awan, A. A., Kunwar, D., & Iftikhar, H. (2025). Unveiling documentation deficiencies: A clinical audit of histopathology request forms at a tertiary care hospital. Annals of Medicine & Surgery, 87(4), 2000–2005. https://doi.org/10.1097/ms9.0000000000003038

Tsagkaris, C., Tagarakis, G., Loudovikou, A., & Zannetos, S. (2025). European trauma policy: A systematic review of European Union institutions and legislation addressing orthopedic surgery and traumatology during and after the COVID-19 pandemic. World Medical and Health Policy, 17(4), 775–790. https://doi.org/10.1002/wmh3.70041

Wong, M. C. (2021). Ultrasound-based assessment and management of postmenopausal bleeding and endometrial polyps. Journal of Medical Ultrasound, 29(4), 227–233. https://doi.org/10.4103/JMU.JMU_142_21

Published

2026-04-29

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Section

Articles