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Cited by 186Endometriosis Research and TreatmentGynecological conditions and treatmentsEctopic Pregnancy Diagnosis and Management

Villar’s nodule: A case report and systematic literature review of endometriosis externa of the umbilicus

Victory, Rahi, Diamond, Michael P., Johns, D. Alan·2007·Journal of Minimally Invasive Gynecology
DOI 10.1016/j.jmig.2006.07.014
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Abstract

We report a case of umbilical endometriosis externa and systematically review the literature regarding this finding. In our case report, a 47-year-old woman with cyclic umbilical bleeding, pelvic pain, and no previous umbilical surgery developed a spontaneous umbilical endometrioma, cured by surgical resection and bilateral salpingo-oophorectomy. In our review, 122 patients with documented umbilical endometriomas from 1966 to the present and 109 cases reported before 1953 were analyzed. Procedures used for diagnosis and/or therapeutic intervention included umbilical biopsy or resection, abdominal wall repair, diagnostic and/or operative laparoscopy, adhesiolysis, hysterectomy, and bilateral salpingo-oophorectomy. Variables included patient age; race; medical and surgical history; past use of oral contraceptives; history of umbilical pain, bleeding, or swelling; duration of signs and symptoms; size and color of the lesion; diagnostic evaluations; and medical or surgical management. Mean age of the study population was 37.7 +/- 0.98 years. Up to 40% of patients with extrapelvic endometriosis present with umbilical endometriomas, with symptoms occurring an average of 17.8 +/- 3.9 months before presentation. Lesions averaged 2.3 +/- 0.2 cm in diameter; were predominantly brown (19.1%), blue (13.2%), or purple (10.3%); and patients frequently had with pain (77.93%), cyclical bleeding (47.1%), and swelling (88.2%). Most patients had no history of endometriosis (73.1%), and laparoscopic, umbilical trocar-related seeding was identified in only 5 patients. Three patients received medical management, and surgical management was invariably curative, though 1 patient required repeat surgical therapy. Umbilical endometriosis is a common manifestation of external endometriosis, representing primary or secondary endometriosis, with a typical presentation that has little variation. Laparoscopic endometrioid tissue excision can result in iatrogenic seeding to the umbilicus. Historical and physical findings are pathognomonic, thus justifying a formal name--Villar's nodule, after the initial reporting physician. Surgical intervention is recommended, but medical therapy may result in long-term symptom control with minimal malignancy risk.

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Crossref · 10.1016/j.jmig.2006.07.014

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  • In a case series review, 67.6% of umbilical endometriosis cases had no history of surgery.

    “Similarly, in a case series review, 67.6% had no history of surgery.”

    From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [46]

  • Symptoms of swelling, pain, or bleeding at umbilical endometriosis lesions were present in 86.5%-90.9%, 80.5%-81.3%, or 44.8%-49.2% of cases, respectively.

    “Symptoms of swelling, pain, or bleeding at the lesions were present in 86.5%‐90.9%, 80.5%‐81.3%, or 44.8%‐49.2% of cases, respectively.”

    From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [46]

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Authors
Victory, R., Diamond, M. P., & Johns, D. A.
Affiliations
  • Wayne State University (US)
  • Texas Health Harris Methodist Hospital Fort Worth (US)
Corresponding author
Victory, Rahi
ORCID
Venue
Journal of Minimally Invasive Gynecology
Publisher
Elsevier BV
Published
2007-01
Volume
14
Issue
1
Pages
23-32
ISSN
1553-4650 (ISSN-L)
DOI
10.1016/j.jmig.2006.07.014
OpenAlex
W2042037929
Cited by
186
References
114
Citations by year
2026: 4 · 2025: 10 · 2024: 8 · 2023: 13 · 2022: 20 · 2021: 14 · 2020: 17 · 2019: 10 · 2018: 9 · 2017: 16 · 2016: 11 · 2015: 3 · 2014: 12 · 2013: 6 · 2012: 13
FWCI
5.53
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Minimally Invasive Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
Keywords
umbilical endometriosis, external endometriosis, endometrioma, umbilical bleeding, bilateral salpingo-oophorectomy, surgical excision, medical therapy, extrapelvic endometriosis, clinical features, lesion characteristics
MeSH terms
Endometriosis, Female, Hemorrhage, Humans, Menstrual Cycle, Middle Aged, Ovariectomy, Sterilization, Tubal, Umbilicus, Pelvic Pain

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