Skip to main content Skip to main navigation menu Skip to site footer

Management options for primary umbilical endometriosis: a case report

  • Hilwah Nora ,
  • Ima Indirayani ,
  • Rusnaidi ,
  • Razi Maulana ,


Background: The common location of Endometriosis is in genitalia organs, for instance, the ovary, uterus, fallopian tube, and sometimes even in the intestine, bladder, and in rare locations such as the navel, lungs, or brain. Umbilical Endometriosis is the most irregular form of Endometriosis and the most common cutaneous form of Endometriosis. Primary umbilical endometriosis diagnosis is often biased and delayed; the exact etiopathology remains unclear. Our case report discusses the diagnosis and management options for this rare disease.

Case presentation: We reported a Primary Umbilical Endometriosis case, confirmed by a history of the nodule with pain, swelling, and bleeding at the umbilicus, which occurs during menstruation. The nodule was surgically removed, and histopathological analysis shows fibromycsoid tissue with multiple forms of subepithelial endometrial glands and surrounding stroma, confirmed as Endometriosis.

Conclusion: The definitive treatment for umbilical Endometriosis is surgical excision with total removal of the umbilicus. The prognosis is good, and the recurrence rate is meager if complete excision is successfully performed.


  1. 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 [Internet]. 2007;14(1):23–32. Available from:
  2. Matalliotakis M, Goulielmos GN, Kalogiannidis I, Koumantakis G, Matalliotakis I, Arici A. Extra pelvic endometriosis: Retrospective analysis on 200 cases in two different countries. Eur J Obstet & Gynecol Reprod Biol [Internet]. 2017;217:34–7. Available from:
  3. Al-Khalili AA, Billick R. Umbilical Endometriosis. Sultan Qaboos Univ Med J [Internet]. 2017/10/10. 2017 Aug;17(3):e371–2. Available from:
  4. Boesgaard-Kjer D, Boesgaard-Kjer D, Kjer JJ. Primary umbilical endometriosis (PUE). Eur J Obstet & Gynecol Reprod Biol [Internet]. 2017;209:44–5. Available from:
  5. Spaziani E, Picchio M, Di Filippo A, Narilli P, Di Cristofano C, Petrozza V, et al. Sporadic diffuse gastric polyposis: Report of a case. Surg Today [Internet]. 2011;41(10):1428–31. Available from:
  6. Van den Nouland D, Kaur M. Primary umbilical endometriosis: a case report. Facts Views Vis Obgyn. 2017;9(2):115-119. PMID: 29209489; PMCID: PMC5707772.
  7. Bagade P V, Guirguis MM. Menstruating from the umbilicus as a rare case of primary umbilical endometriosis: a case report. J Med Case Rep [Internet]. 2009 Dec 10;3:9326. Available from:
  8. 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. PMID: 19784526.
  9. Savelli L, Manuzzi L, Di Donato N, Salfi N, Trivella G, Ceccaroni M, et al. Endometriosis of the abdominal wall: ultrasonographic and Doppler characteristics. Ultrasound Obstet & Gynecol [Internet]. 2012;39(3):336–40. Available from:
  10. Kyamidis K, Lora V, Kanitakis J. Spontaneous cutaneous umbilical endometriosis: Report of a new case with immunohistochemical study and literature review. Dermatol Online J [Internet]. 2011;17(7). Available from:
  11. Capobianco G, Cherchi PL, Rubattu G, Fattorini F, Canetto AM, Dessole S. Immunohistochemical evaluation of a new epithelial antigen, ber-ep4 in ovarian cancer. Int J Gynecol Cancer [Internet]. 2003;13(Suppl 1):11.1-11. Available from:
  12. Rzepecki AK, Birnbaum MR, Cohen SR. A Case of Primary Umbilical Endometriosis. J Cutan Med Surg [Internet]. 2018;22(3):325. Available from:
  13. Mechsner S, Bartley J, Infanger M, Loddenkemper C, Herbel J, Ebert AD. Clinical management and immunohistochemical analysis of umbilical endometriosis. Arch Gynecol Obstet [Internet]. 2008;280(2):235–42. Available from:
  14. Eğin S, Pektaş BA, Hot S, Mihmanlı V. Primary umbilical endometriosis: A painful swelling in the umbilicus concomitantly with menstruation. Int J Surg Case Rep [Internet]. 2016/09/23. 2016;28:78–80. Available from:
  15. 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. PMID: 19111147.
  16. Obata K, Ikoma N, Oomura G, Inoue Y. Clear cell adenocarcinoma arising from umbilical endometriosis. J Obstet Gynaecol Res [Internet]. 2012;39(1):455–61. Available from:
  17. Jutidamrongphan W, Chayovan T, Tubtawee T, Hongsakul K. A rare case report of extensive abdominopelvic endometriosis mimicking peritoneal malignancy: an imaging investigation. Bali Med J [Internet]. 2020;9(2):582. Available from:

How to Cite

Nora, H., Indirayani, I. ., Rusnaidi, & Maulana, R. . (2022). Management options for primary umbilical endometriosis: a case report. Bali Medical Journal, 11(3), 1760–1763.