Case History/Examination

A 43‐year‐old woman presented with a one‐year history of intermittent periumbilical pain that worsened cyclically with menstruation. Recently, she experienced a marked increase in pain intensity along with the onset of bloody discharge from the umbilicus, accompanied by nausea and vomiting. Her medical history was notable for two previous cesarean sections performed several years earlier. On physical examination, a firm, immobile subcutaneous mass measuring approximately 4 × 4 cm was palpated beneath the umbilicus, with overlying brownish, edematous skin containing two sinus‐like openings (Figure 1). Tenderness was localized to the umbilical region, with no abnormalities noted elsewhere in the abdomen.

FIGURE 1: Gross appearance of the umbilical lesion. A firm, brownish nodular mass measuring approximately 4 × 4 cm is visible beneath the umbilicus, with overlying edematous skin and two sinus‐like openings. Patient consent was obtained for photography.