Umbilical Endometriosis: A Rare Diagnosis in Plastic and Reconstructive Surgery

Umbilical endometriosis infrequently presents to the plastic surgeon. As such, the diagnosis is difficult to make because it is often overlooked. The current report presents a 35-year-old nulligravid woman with a six-month history of a firm, cyclically swelling lesion in her umbilical region. None of the signs characteristic of pelvic endometriosis except dysmenorrhea and a one-year history of infertility were present. Biopsy of the lesion revealed umbilical endometriosis (grade IV), and laparoscopy uncovered extensive disease. Monopolar cautery with coagulating current umbilical excision and reconstruction with a purse-string suture was used. The results underscore the importance of a broad differential diagnosis for an umbilical lesion in a middle-age woman. They also highlight the importance of early recognition and appropriate surgical intervention to minimize morbidity and mortality associated with umbilical endometriosis.