Umbilical port-site endometriosis: a case presentation and narrative review of the literature.

Introduction: Umbilical port-site endometriosis is a rare form of abdominal wall endometriosis (AWE), especially following non-gynecologic surgeries. Diagnosing AWE is challenging because it mimics other abdominal wall masses. Content: We describe a 46-year-old woman with cyclic umbilical pain and a mass at a previous trocar site, 17 years after laparoscopic cholecystectomy. Her history included two earlier cesarean sections, both recognized risk factors for iatrogenic AWE. Imaging demonstrated a vascularized lesion. Surgical excision confirmed endometriosis. A narrative review of the literature (2000-2025) was conducted using PubMed, Scopus, and Google Scholar. Broad inclusion criteria were applied; SANRA principles guided quality appraisal. A basic quantitative summary of reported cases was included. Summary: Twenty-seven relevant publications were included. Port-site AWE remains rare, and standardized diagnostic pathways and follow-up protocols are lacking. Most cases were managed with wide local excision with negative margins. Recurrence data are sparse due to short or absent follow-up in many reports. Outlook: Clinicians - particularly general surgeons - should consider AWE in patients with painful masses at trocar or scar sites. Although the temporal association with cholecystectomy raises suspicion, prior cesarean sections provide a more plausible etiological source in this case. Long-term follow-up and international registries are needed to better characterize outcomes of port-site endometriosis.