An umbilical bleeding nodule

Description

A 23-year-old woman was referred to the dermatology department through the 2-week wait pathway under clinical suspicion of malignant melanoma in the umbilical region. She presented with a 4-month history of a painful and intermittently bleeding nodule on the umbilical area. The lesion was more prominent during her menstrual cycles and bled. She was otherwise in good general health and denied a history of abdominal or gynaecological surgery. There was no known medical history of endometriosis.

On physical examination, she presented with approximately 1.5 cm soft, brown, well-circumscribed nodule on the inferior aspect of the umbilical area (figure 1). Based on her medical history and examination findings, umbilical endometriosis was suspected. A cutaneous biopsy was performed, which showed endometrial glands and stroma without atypia and scattered siderophages (figure 2). The patient was referred to the gynaecology team for further investigation. Ultrasound studies and abdominal/pelvic...

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