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.