Introduction: Endometriosis is a common gynecological condition and presents mainly with involvement of the pelvic organs. Extrapelvic presentations in almost all parts of the body have been reported in the literature. However, umbilical endometriosis that is spontaneous or secondary to surgery is uncommon and accounts for only 0.5% to 1% of all endometriosis cases. We report a recently observed case of primary Umbilical Endometriosis (UE), with the main aim to discuss the management of this rare condition.

Presentation of case: A 35-year-old woman P2L2, NFVD complained of a painful nodule on her umbilical region, bleeding with her menstrual cycle. Ultrasonography showed a hypoechoic lesion with cyctic area 2.1 x 2.8 x 1.8 cm in the umbilicus and no signs of intra-abdominal endometriosis. Wide Excision with 3cm margin of the nodule under spinal anesthesia was performed. Histopathological analysis confirmed the diagnoses that the patient was asymptomatic at follow-up, but nevertheless warned of the risk of recurrence of umbilical endometriosis.

Discussion: Pelvic endometriosis is a common condition, but the diagnosis of primary umbilical endometriosis is difficult and differentials should be considered. Although there is a substantial agreement about the necessity of surgery, treatment options are either local excision of the lesion or removal of the whole umbilicus with or without laparoscopic exploration of the peritoneal cavity. The decision should be tailored for the individual patient, taking into consideration the size of the lesion, the duration of symptoms and the presence of possible pelvic endometriosis.

Conclusion: Wide local excision may be the treatment of choice in patients with UE lesions and differential diagnosis of endometriosis should be considered when an umbilical swelling presents in a woman of reproductive age. No recurrence noted in our in this case after follow up for 1 year.

An 87-year-old woman presented night-time at accident & emergency department with severe abdominal pain. Vital signs and blood tests were unremarkable. A CT scan abdomen-pelvis showed also no significant abnormality apart from sigmoid diverticular disease without signs of inflammation and a gastric distension likely reflecting gastritis.

The pain initially settled but about 12 hours later represented. Vitals were still within normal range; abdomen was tender but soft with no guarding and mildly distended. A chest x-ray was thus requested urgently.

Organ transplantation has become an essential treatment for saving and prolonging lives in a wide range of clinical disorders. It is a complex procedure and often convoluted by distinct issues related to clinical outcome and number of donors [1]. Recent attempts to overcome these problems have been demonstrated in the field of regenerative medicine [2]. Regenerative medicine is a branch of medicine involved in the development of methods for the regeneration and repair of tissues and organs damaged by age, diseases or congenital defects. It encompasses numerous strategies including the use of biomaterials, stem cells and bio-cues or any combinations thereof, to promote tissue healing [3]. In this context, Human Bone Marrow Stromal Stem Cells (MSCs) have proved to be an effective source for transplantation due to their capacity to self-renew and differentiate both in in vitro and in vivo while restraining concerns regarding immune response and ethical and legal administration [4].