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

Authors

  • Rakesh A. Hasabe B. K. L. Walawalkar Rural Medical College and Hospital, Ratnagiri, Maharashtra, India
  • Neha S. Tripathi Wingate University, Wingate, NC, USA
  • Prajakta Kesarkodi B. K. L. Walawalkar Rural Medical College and Hospital, Ratnagiri, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20221469

Keywords:

Umbilical endometriosis, Menstruating umbilicus, Subcutaneous umbilical endometriosis

Abstract

This paper described 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 reinforced 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 emphasized the importance of early diagnosis of UE in order to avoid extensive abdominal wall surgery.

Author Biography

Rakesh A. Hasabe, B. K. L. Walawalkar Rural Medical College and Hospital, Ratnagiri, Maharashtra, India

Dr. Rakesh Hasabe is an OBGYN and advanced laparoscopic surgeon in Maharashtra. He is a Member of the National Academy of Medical Sciences and has multiple fellowships in minimal access surgery, assisted reproductive technologies, and advanced gynecological laparoscopy. A national-level gold medalist in minimal access surgery, he is a rising star in gynecology with a fast-growing professional presence because of his successful online educational endeavors to spread awareness, increase access, and provide knowledge about laparoscopy amongst budding surgeons via his YouTube channel and popular social media handles on Instagram and Facebook. He has performed over thousands of advanced gynecological surgeries, including hundreds of minimal access procedures. He is currently an Assistant Professor inOBGYNat BKL Walavalkar Rural Medical College & Hospital in Ratnagiridistrict.

References

Efremidou EI, Kouklakis G, Mitrakas A, Liratzopoulos N, Polychronidis AC. Primary umbilical endometrioma: a rare case of spontaneous abdominal wall endometriosis. Int J Gen Med. 2012;5:999-1002.

Rosina P, Pugliarello S, Colato C, Girolomoni G. Endometriosis of umbilical-cicatrix: case report and review of the literature. Acta Dermatovenerol Croat. 2008;16(4):218-21.

Victory R, Diamond MP, Johns DA. Villar’s nodule: a case report and systematic literature review of endometriosis externa of the umbilicus. J Minim Invasive Gynecol. 2007;14(1):23-32.

Falco MD, Ragusa M, Oliva G, Miranda A, Parmeggiani D, Sperlongano P, et al. Is extrauterine endo- metriosis confined to the gynecological sphere? A critical review of the experience in a general surgery unit. G Chir. 2007;28(3):83-92.

Spaziani E, Filippo CEO, Picchio M, Briganti M, Cristofano CD, Ceci F, et al. Primary umbilical endometriosis. Clinical case. Giornale Di Chirurgia. 2009;30(5):230-3.

Victory R, Diamond MP, Johns DA. Villar’snodule:a case report and systematic literature review of endometriosis externa of the umbilicus. J Minim Invasive Gynecol. 2007;14(1):23-32.

Chatzikokkinou P, Thorfinn J, Angelidis IK, Papa G, Trevisan G. Spontaneous endometriosis in an umbilical skin lesion. Acta Dermatovenerol Alp Pannonica Adriat. 2009;18(3):126-30.

Kyamidis K, Lora V, Kanitakis J. Spontaneous cutaneous umbilical endometriosis: report of a new case with immunohistochemical study and literature review. Dermatol Online J. 2011;17(7):5.

Capasso L, Sciano D, Iarrobino G. L’endometriosi extrauterina: tre nuovi casi. Giornale Di Chirurgia. 2004;25(1-2):39-42.

Ferhatoglu MF, Senol K. Primary abdominal wall endo- metriosis: presentation of rarely seen two cases. Il Giornale di Chirurgia. 2018;39(2):107-10.

Dunselman GA, Vermeulen N, Becker C, Calhaz‐Jorge C, D’Hooghe T, DeBie B, et al. ESHRE guideline: Management of women with endometriosis. Hum Reprod. 2014;29(3):400‐12.

Lauslahti K. Malignant external endometriosis. A case of adenocarcinoma of umbilical endometriosis. Acta Pathol Microbiol Scand Suppl. 1972;233:98-102.

Obata K, Ikoma N, Oomura G, Inoue Y. Clear cell adenocarcinoma arising from umbilical endometriosis. J Obstetr Gynaecol Res. 2013;39(1):455-61.

Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789-99.

Mechsner S, Bartley J, Infanger M, Loddenkemper C, Herbel J, Ebert AD. Clinical management and immunohistochemical analysis of umbilical endometriosis. Arch Gynecol Obstet. 2009;280(2):235-42.

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Published

2022-05-26

Issue

Section

Case Reports