Umbilical endometriosis, our experience.

BACKGROUND Endometriosis is the presence of functioning endometrial tissue outside the uterine cavity. Umbilical endometriosis has been reported in more than one hundred cases and the umbilicus represents the location of 0.5-1% of ectopical endometrioses. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. PATIENTS AND METHODS We report our experience in preoperative differential diagnosis and treatment of four cases of umbilical endometriosis. An accurate anamnesis and clinical examination together with the use of 13 MHz probe ultrasonography with echocolor duplex scan led us to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. RESULTS AND CONCLUSION In all treated cases, a hemi-circumferential incision in the inner aspect of the umbilical opening was performed allowing adequate access to the lesion and umbilical repositioning. At the follow-up visit (from 6 to 24 months after surgery), no symptoms or signs of recurrence were evidenced. A natural-looking umbilicus was observed in all cases with minimal visible scars.

[1]  S. Sinha,et al.  Umbilical Endometriosis Associated with Umbilical Hernia , 2009 .

[2]  Alfonso Baldi,et al.  Endometriosis: pathogenesis, diagnosis, therapy and association with cancer (review). , 2008, Oncology reports.

[3]  R. Ruggiero,et al.  Umbilical endometriosis associated with umbilical hernia. Management of a rare occurrence. , 2007, Chirurgia italiana.

[4]  Rodrigo Ayala Yáñez,et al.  [Endometriosis: physiopathology and investigation trends (first part)]. , 2007, Ginecologia y obstetricia de Mexico.

[5]  Y. Pabuscu,et al.  The significance of venous dominance in color Doppler ultrasound for the diagnosis of primary nodular skin lesions: a new perspective in classification. , 2006, Clinical imaging.

[6]  B. Holloway,et al.  Case report: MR imaging features of endometriosis at the umbilicus. , 2005, The British journal of radiology.

[7]  G. Campus,et al.  Endometriosis in a trocar tract: is it really a rare condition? A case report. , 2005, Minerva chirurgica.

[8]  P. Rubegni,et al.  Case 4 , 2003, Clinical and experimental dermatology.

[9]  P. Carli,et al.  Cutaneous endometriosis: non‐invasive analysis by epiluminescence microscopy , 2003, Clinical and experimental dermatology.

[10]  J. Dietl,et al.  Umbilical endometriosis without previous pelvic surgery: a case report , 2003, Archives of Gynecology and Obstetrics.

[11]  T. Falcone,et al.  Endometriosis: still tough to diagnose and treat. , 2002, Cleveland Clinic journal of medicine.

[12]  J. Borrello,et al.  MR Appearance of Umbilical Endometriosis , 1994, Journal of computer assisted tomography.

[13]  A. Darzi,et al.  Endometriosis and umbilical swelling. , 1994, Clinical and experimental obstetrics & gynecology.

[14]  J. Rock,et al.  Extrapelvic endometriosis. , 1989, Obstetrics and gynecology clinics of North America.

[15]  D. Joly,et al.  Endométriose de la paroi abdominale dans les suites à long terme d'une cérasienne , 1988 .

[16]  A. Srivastava,et al.  Doppler ultrasound as an adjunct to the differential diagnosis of pigmented skin lesions , 1986, The British journal of surgery.

[17]  M. Houcke,et al.  [Umbilical endometriosis]. , 1968, Bulletin de la Federation des societes de gynecologie et dobstetrique de langue francaise.

[18]  J. Moir.  Endometriosis of the Umbilicus , 1944, Proceedings of the Royal Society of Medicine.

[19]  J. Sampson.  The development of the implantation theory for the origin of peritoneal endometriosis , 1940 .