Cutaneous Endometriosis: A Differential Diagnosis of Umbilical Nodule

Abstract

Endometriosis is a chronic disorder characterized by the presence of ectopic functional endometrial tissue outside the uterine cavity and which affects about 10% of all women of reproductive age. Cutaneous endometriosis, usually localized in the abdominal wall, is a rare entity. We report the case of a nulliparous woman with an acute painful umbilical nodule that slowly increased in size during the days prior to observation. The lesion was surrounded by a painful periumbilical subcutaneous plaque. The patient denied associated constitutional symptoms and reported two similar episodes in the previous two years. A skin biopsy was performed, and histopathologic examination was consistent with the diagnosis of endometriosis. This article reviews this disease particularly rare in nulliparous and highlights the importance of recognizing this clinical presentation of endometriosis due to its frequent association with pelvic disease that can lead to reduced fertility.

A multilobulated asymptomatic umbilical nodule revealing endometriosis

“…The incidence of this disease is about 0.5 to 1% of extrapelvic endometriosis. 2 It mostly occurs in female of reproductive age and is usually characterized by a discolored painful mass of the umbilicus with cyclic bleeding and/or swelling according to the menstrual cycle. 3 In the study of Santos and coworkers, the mean age was 33 years; all patients had a complaint from pain and bleeding in the menstruation period.…”

“…Primary umbilical endometriosis (PUE) occurs spontaneously and is a very rare benign condition. The incidence of this disease is about 0.5 to 1% of extrapelvic endometriosis 2 . It mostly occurs in female of reproductive age and is usually characterized by a discolored painful mass of the umbilicus with cyclic bleeding and/or swelling according to the menstrual cycle 3 .…”

Cutaneous Endometriosis: a rare medical entity

“…The etiology of primary cutaneous endometriosis is still unclear, possible theories suggest that endometrial cells migrate to the umbilicus through the abdomen or lymphatic system, or even by the presence of remnants of embryonic cells in the umbilical fold. One can also imagine that the umbilicus acts as a physiological scar of predilection for ectopic endometrial implants since umbilical cutaneous endometriosis is more incident in cases of cutaneous endometriosis (Batista et al;Raffi et al, 2019).…”

Skin endometriosis at the caesarean section scar: a case report

“…The most effective treatment of cutaneous endometriosis It is the surgical one. In the exeresis the focus of endometriosis with wide margins of 5-10 mm may be done with the intention of avoiding recurrence [3,10,11].…”