The published case report describes a perimenopausal woman who experienced a slowly enlarging lump in her navel for approximately one year. The mass periodically bled during menstruation, a symptom that eventually became a critical diagnostic clue. Despite the cyclical bleeding, the patient had no previous surgical history, no systemic illness, and no major abdominal complaints, making the condition particularly difficult to identify at an early stage.
Endometriosis is a chronic inflammatory condition in which tissue similar to the uterine lining grows outside the uterus. Most cases occur within the pelvic cavity, affecting the ovaries, fallopian tubes, or surrounding pelvic tissues. However, about 12 percent of cases are considered extragenital, meaning the lesions appear in areas outside the reproductive organs. Umbilical endometriosis is among the rarest forms, accounting for only around 0.5 to 1 percent of all endometriosis cases.
According to Ismu Nugroho from Universitas Airlangga, rare manifestations such as umbilical endometriosis are often overlooked because they resemble more common conditions such as umbilical hernias, granulomas, cysts, or metastatic cancer nodules. The absence of previous surgery further complicates diagnosis because many clinicians associate umbilical endometriosis with postoperative scar implantation.
The study was conducted using a qualitative descriptive case-study approach. Researchers collected longitudinal clinical data from the patient, including medical history, physical examination findings, ultrasound imaging, CT scan results, surgical observations, and histopathological analysis. The case was followed for one year after treatment to monitor recovery and possible recurrence.
Medical imaging revealed a solid hypoechoic mass measuring approximately 3.16 × 3.37 × 2.8 centimeters with peripheral vascularization. CT scans showed increased lesion density after contrast injection, indicating strong blood supply within the abnormal tissue. Additional imaging also suggested possible pelvic involvement, including bilateral adnexal cystic lesions and thickening of the posterior uterine wall.
The patient underwent wide surgical excision of the umbilical mass. During surgery, doctors found that the lesion had not deeply invaded surrounding fascia, allowing complete removal without extensive reconstructive procedures. Histopathological examination later confirmed the presence of ectopic endometrial glands and stromal tissue in the umbilical area, establishing a definitive diagnosis of primary umbilical endometriosis.
One of the most significant findings in the study was the patient’s recovery outcome. After one year of postoperative monitoring, no recurrence, residual mass, or repeated bleeding was observed. The successful outcome supports wide excision as the most effective treatment strategy for this rare condition.
The report also contributes important information to global medical literature because the patient was 52 years old and still menstruating regularly. Previous studies generally reported an average patient age of around 37 years. This case demonstrates that hormonal activity during perimenopause can still support the growth of endometriosis lesions outside the reproductive system.
Researchers noted that the biological mechanism behind primary umbilical endometriosis remains under debate. Some theories suggest that endometrial cells spread through blood vessels or lymphatic channels before implanting in the umbilical region. Other hypotheses involve embryonic remnants within umbilical tissue that may allow abnormal cell growth under hormonal influence.
The case highlights broader healthcare concerns regarding women’s health diagnostics. Many women with uncommon gynecological symptoms experience delayed diagnosis because their conditions mimic more familiar diseases. In this case, cyclical bleeding from the navel became the key indicator that differentiated endometriosis from malignant or infectious lesions.
The findings also reinforce the importance of integrating imaging technology with histopathological confirmation. While ultrasound and CT scans helped define the lesion’s structure and vascularization, laboratory tissue analysis remained the gold standard for diagnosis.
In the discussion section of the study, Ismu Nugroho of Universitas Airlangga emphasized that clinicians should maintain a high index of suspicion when evaluating umbilical masses in women, particularly when symptoms fluctuate with menstrual cycles. Early recognition can prevent unnecessary anxiety, reduce misdiagnosis, and improve long-term patient outcomes.
The research may influence future clinical guidelines related to rare forms of extragenital endometriosis. It also has practical implications for surgeons, radiologists, gynecologists, and primary-care physicians who frequently encounter unexplained abdominal lesions. Increased awareness could improve diagnostic accuracy and encourage earlier intervention before complications develop.
Although malignant transformation of umbilical endometriosis is considered extremely rare, the study notes that several documented cases worldwide have shown cancerous progression. This risk further supports the recommendation for complete surgical removal and careful pathological examination of suspicious umbilical masses.
Author Profile
Ismu Nugroho is a medical researcher and academic affiliated with Universitas Airlangga. His work focuses on clinical case studies, surgical management, and gynecological disorders, particularly rare disease manifestations that require multidisciplinary diagnostic approaches.
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