Umbilical Endometriosis With Appendiceal Involvement: A Case Report

Endometriosis is a common disease that affects women worldwide. While it is most commonly located in the pelvis, lesions may occur in other areas of the body. Concurrent umbilical and appendiceal endometriosis is rare. We present a case of umbilical endometriosis with appendiceal involvement in a 29-year-old female. The patient presented with a periumbilical mass that bled during her menstrual cycle. She also reported lower quadrant pelvic pain, dysmenorrhea, and dyspareunia. Imaging revealed an umbilical hernia and a lesion abutting the suspensory ligament of the right ovary. Cancer antigen-125 (CA-125) levels were elevated. Diagnostic laparoscopy revealed stage IV endometriosis with severe adhesions to the uterus, posterior cul-de-sac, descending and sigmoid colon, and bladder. An incidental appendiceal mass was noted, resulting in an appendectomy. The periumbilical mass was removed. Pathology revealed umbilical and appendiceal endometriosis. There were no complications in the postoperative period. The diverse manifestations of endometriosis emphasize the importance of considering extrapelvic involvement, especially in patients with atypical dermatological symptoms. Early recognition and subsequent laparoscopy for both the diagnosis and treatment of endometriosis are essential for successful patient management.