Primary Umbilical Endometriosis Fine Needle Aspiration Cytology Diagnosis: Case Report and Literature Review

Introduction Umbilical endometriosis is a rare form of endometriosis accounting for 0.5-1% of total cases of endometriosis. It may occur in the setting of prior abdominopelvic surgical procedures or spontaneously, where the latter is more common. The classic clinical presentation is red or black painful nodule with cyclical nature of pain. Initial diagnosis is usually made clinically but histopathologic confirmation is required. Fine needle aspiration cytology is also diagnostic for endometriosis. This case report is aimed to highlight the role of Fine needle aspiration cytology in diagnosing endometriosis, and discus the clinical presentation, pathogenesis and diagnosis of primary umbilical endometriosis with review of previously published case reports. Presentation of Case A 24 years old nulliparous woman presented with slowly growing umbilical swelling and pain of 02 years duration. The pain worsens with menses. She had no history of previous surgical procedure. On physical examination there was well defined, non-tender, firm mobile subcutaneous mass with overlying skin hyperpigmentation measuring, 23mm*19mm. Fine needle aspiration cytology was done from the nodule and the findings were consistent with endometriosis. Subsequent histopathologic examination also confirmed the diagnosis of endometriosis. Conclusion Even though it is rare, primary umbilical endometriosis should be considered in a women of reproductive age group presenting with painful umbilical mass. With favorable clinical setting, fine needle aspiration cytology is cost effective, fast and accurate diagnostic modality in diagnosing umbilical endometriosis.