Cutaneous endometriosis represents an unusual ectopic growth of endometrial tissue outside the uterine cavity. We present a case of spontaneous (primary) cutaneous endometriosis of the umbilicus with review of the appropriate literature. Our patient is a 30-year-old African American female, with no previous surgical history, who presented to our dermatology clinic with concern regarding nodules in her umbilicus. According to the patient, the nodules were associated with cyclical pain, episodic bleeding and fluctuation in size. Dermatological examination revealed multiple 5-6 mm reddish-blue, dome shaped papules within the umbilicus. Following shave biopsy, histological examination revealed endometrial glands surrounded by fibrotic, mucinous stroma and erythrocyte extravasation with hemosiderin deposition. Also identified, were ductal structures with cilia on the internal lining. The lesions were diagnosed as cutaneous endometriosis with cilia. The patient was referred to plastic surgery for local excision and gynecology for assessment of endometriosis in the pelvic cavity.
Katherine Braunlich, Gregory Delost, Kord Honda and Jenifer Lloyd