title: [Umbilical endometriosis without previous pelvic surgery].
abstract: OBJECTIVE
  to present a series of cases of umbilical endometriosis in patients in reproductive age, with no previous pelvic surgery.
  
  
  METHODS
  four patients aged between 33 and 43 years were included in the study. They all presented umbilical bleeding associated or not with pelvic pain, and medical history varied from two months to four years. Abdominal wall ultrasound was performed for diagnosis support before surgical excision of the umbilical lesions, and histological examination was also performed.
  
  
  RESULTS
  the ultrasonographic evaluation of the four patients showed hypoechogenic umbilical lesion suggestive of endometriosis. All patients were submitted to surgical excision and histological examination of the lesions. CA-125 serum levels were measured in three of the patients, but they were within normal ranges (from 6.8 to 10.1 U/mL). In addition to umbilical surgery, laparoscopy was performed in all patients, but only one presented concomitant pelvic endometriosis. In a one-year follow-up, patients maintained asymptomatic and there was no recurrence of the lesions.
  
  
  CONCLUSIONS
  umbilical endometriosis is a rare entity, but it may be remembered as a possibility in cases of umbilical nodulations or bleeding, even if there is no previous history of pelvic surgery with endometrial manipulation. Its treatment is always surgical and, in general, it is enough to promote complete elimination of the lesion and of the symptoms.
authors.affiliation: Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil.
authors.forename: Bruno Ramalho de
authors.initials: BR
authors.lastname: Carvalho
authors.forename: Júlio César
authors.initials: JC
authors.lastname: Rosa e Silva
authors.forename: Ana Carolina Japur de Sá
authors.initials: AC
authors.lastname: Rosa e Silva
authors.forename: Hermes de Freitas
authors.initials: Hde F
authors.lastname: Barbosa
authors.forename: Omero Benedicto
authors.initials: OB
authors.lastname: Poli Neto
authors.forename: Francisco José Cândido dos
authors.initials: FJ
authors.lastname: Reis
authors.forename: Antônio Alberto
authors.initials: AA
authors.lastname: Nogueira
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D014472:Umbilicus