Menstruating umbilicus! A rare case report of primary umbilical endometriosis with review of literature


  • Renuka Malik Department of Obstetrics and Gynaecology, PGIMER, RML Hospital, New Delhi, India
  • Preeti Sharma Department of Obstetrics and Gynaecology, PGIMER, RML Hospital, New Delhi, India



Umbilical nodule, Extra pelvic endometriosis, Primary umblical endometriosis


Umbilical endometriosis (UE) represents 0.5% to 1% of all cases of extra genital endometriosis. Primary umbilical endometriosis is the presence of ectopic endometrial tissue located in the umbilicus in absence of previous surgery for either gynecological disorders or cesarean section which is defined as secondary umbilical endometriosis. Secondary UE, which is more common than primary UE and is probably due to the iatrogenic dissemination and implant of endometrial cells during either laparoscopic or open surgical procedures. Mrs. X, presented in OPD with an umbilical nodule since 6 months which grew in size and became painful and bled during periods. Imaging studies were done including MRI. A provisional diagnosis of umbilical endometriosis was made as patient had no history of any prior surgery. Patient had no suggestive history of pelvic endometriosis. Diagnostic laparoscopy was done to rule out concomitant pelvic endometriosis followed by wide local excision and umbilical reconstruction was done. By plastic surgeons. Knowledge of this rare condition and correct management is important to avoid recurrence. Medical treatment is only palliative not definitive in this condition.


Fancellu A, Pinna A, Manca A, Capobianco G, Porcua A. Primary umbilical endometriosis. Case report and discussion on management options. Int J Surg Case Rep. 2013;4(12):1145-8.

Mizutani T, Sakamoto Y, Ochiai H, Maeshima A. umbilical endometriosis with urachal remnant. Arch Dermatol. 2012;148(11):1331-2.

Calagna G, Perino A, Chianetta D, Vinti D, Triolo MM, Rimi C, et al. Primary umbilical endometrioma: analyzing the pathogenesis of endometriosis from an unusual localization. Taiwanese Journal of Obstetrics and Gynecology. 2015;54(3):306-12.

Pallavi VB, Giurguis MM. Menstruating from the umbilicus as a rare case of primary umbilical endometriosis: a case report. J Med Case Rep. 2009;3:9326.

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

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

Obata K, Ikoma N, Oomura G, Inoue Y. Clear cell adenocarcinoma arising from umbilical endometriosis. Journal of Obstetrics and Gynaecology Research. 2013;39:455-61.

Fedele L, Frontino G, Bianchi S, Borruto F, Ciappina N. Umbilical endometriosis: a radical excision with laparoscopic assistance. Int J Surg. 2010;8(2):109-11.






Case Reports