Multidisciplinary management of primary umbilical endometriosis (Villar’s nodule) with coexistent uterine leiomyomata: A case report

Introduction: Primary umbilical endometriosis, also known as Villar’s nodule, is a rare manifestation of endometriosis within the umbilicus. Case description: A 41-year-old female who presented with a 4-year history of umbilical swelling associated with cyclic umbilical bleeding, dysmenorrhoea and heavy menstrual bleeding is herewith reported. Imaging procedures revealed an umbilical mass and uterine leiomyomas. The patient underwent combined surgery by the gynaecology and plastic surgery teams where an open myomectomy followed by omphalectomy, mesh repair of the rectus sheath and panniculectomy was done. Histopathological examination confirmed the presence of estrogen and progesterone receptor-positive endometrial glands and stroma in the umbilicus consistent with primary umbilical endometriosis and coexistent uterine leiomyomas. Clinical improvement was demonstrated 3 months following the surgery. Conclusion: Umbilical swelling associated with catamenial symptoms should raise suspicion for primary umbilical endometriosis. Inter-specialty approach is key in the management of primary umbilical endometriosis.