title: Primary umbilical endometriosis. Case report and discussion on management options.
abstract: BACKGROUND
  We report a recently observed case of primary umbilical endometriosis (UE), with the main aim to discuss the management of this rare condition.
  
  
  METHODS
  A 24-year-old woman complained of a painful nodule on her umbilical region, bleeding with her menstrual cycle. Ultrasonography showed a hypoechoic superficial mass in the umbilicus and no signs of intra-abdominal endometriosis. Excision of the nodule under local anesthesia was performed. Histopathological analysis confirmed the diagnosis of umbilical endometriosis. Neither symptoms nor signs of local recurrence have been observed after 24 months.
  
  
  CONCLUSIONS
  UE should be taken into account in differential diagnosis of umbilical disorders even in young nulliparous women with no typical symptoms of pelvic endometriosis. Although there is a substantial agreement about the necessity of surgery, treatment options are either local excision of the lesion or removal of the whole umbilicus with or without laparoscopic exploration of the peritoneal cavity. The decision should be tailored for the individual patient, taking into consideration the size of the lesion, the duration of symptoms and the presence of possible pelvic endometriosis.
  
  
  CONCLUSIONS
  Local excision saving the umbilicus may be the treatment of choice in patients with small UE lesions.
authors.affiliation: Department of General Surgery 2 - Clinica Chirurgica, University of Sassari, V.le San Pietro 43, 07100 Sassari, Italy. Electronic address: afancel@uniss.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fancellu
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinna
authors.forename: Alessandra
authors.initials: A
authors.lastname: Manca
authors.forename: Giampiero
authors.initials: G
authors.lastname: Capobianco
authors.forename: Alberto
authors.initials: A
authors.lastname: Porcu
keywords: Endometriosis; Treatment; Umbilicus