Primary umbilical endometriosis: case report

Introduction: Endometriosis is defined as the presence of endometrial tissue, including glands and stroma, located outside of the uterine cavity. Case report: We report the case of a 26-year-old patient who presents cyclical omphalorrhagia. Upon physical examination, a bluish nodule at the umbilical level and a tumor in the retro-cervical septum are found. Diagnosis is made of primary umbilical endometriosis (PUE) and deep endometriosis. Umbilical nodule resection and confirmatory diagnostic laparoscopy are performed, with good evolution afterwards. In relation to the pathophysiology of endometriosis, it is considered a chronic disease which includes genetic, epigenetic, inflammatory and hormone-dependent factors. As for PUE, vascular or lymphatic dissemination may explain the presence of umbilical implants. Another theory for this is coelomic metaplasia. Conclusions: PUE is an extremely rare condition, with only 59 reported cases in the last 25 years. Its treatment of choice is surgical.