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The patient exhausted medical management options, then pursued surgical management via umbilectomy, excision of umbilical endometriosis, lysis of adhesions and umbilical hernia repair. Surgical pathology revealed cystic endometriosis within a hernia sac. Postoperative course was complicated by a surgical site infection, which resolved with antibiotic treatment and ultrasound-guided percutaneous drainage. Few theories attempt to explain the pathogenesis of umbilical endometriosis. Medical management has not been well studied but may prove to be an effective first-line adjuvant strategy. Surgical management is reported to have a low-recurrence rate. Many techniques have been described for umbilical reconstruction, but a superior surgical technique has yet to be identified. The case presented discusses the management of a secondary endometrioma in an umbilical hernia.<\/jats:p>","DOI":"10.1136\/bcr-2024-262465","type":"journal-article","created":{"date-parts":[[2025,1,19]],"date-time":"2025-01-19T20:50:35Z","timestamp":1737319835000},"page":"e262465","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Surgical management of umbilical endometrioma within an umbilical hernia"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6106-5324","authenticated-orcid":false,"given":"Nicole","family":"Cumbo","sequence":"first","affiliation":[{"name":"OB\/Gyn, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Leung","sequence":"additional","affiliation":[{"name":"OB\/Gyn, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey, 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