Primary umbilical endometriosis with cyclic bleeding

Umbilical endometriosis is a rare clinical entity with unclear pathogenesis. A 36-year-old woman who presented with painless umbilical bleeding during the menstrual period for 9？months, history of dysmenorrhea for 10？years ago without medial used for relieving pain. A painless, 2-cm superficial hyperpigmented dark nodule with an orifice located in an umbilicus had been revealed during physical examination. The ultrasonography showed a 2.6-cm right hypoechogenic ovarian cyst and a 2.37-cm umbilical mass. The operation was umbilical lesion excision, laparoscopic enucleation of right endometrioma and surgical excision of endometriosis at the uterosacral ligament which revealed endometriosis on microscopic examination. The umbilicus had performed for neo-umbilicus suturing. Postoperative was uneventful. The concomitant endometriosis of the umbilicus, right endometrioma and the uterosacral ligament is rarely reported in the literature