<![CDATA[Primary umbilical endometriosis is an exceptionally rare extragenital manifestation often misdiagnosed due to its clinical similarity to other umbilical masses, especially in patients without prior pelvic surgery. This study aims to analyze the diagnostic process and surgical intervention effectiveness in a perimenopausal patient. A qualitative descriptive case study was conducted on a 52-year-old woman selected via purposive sampling. Data were gathered through longitudinal clinical documentation, including medical history, physical examination, and radiological evaluations (ultrasound and CT scans), confirmed by histopathological reports. Results identified a 3.16 × 3.37 × 2.8 cm hypoechoic solid mass with peripheral vascularization and increased post-contrast density, manifesting as cyclic bleeding. Management through wide excision successfully achieved total removal, with histopathology confirming umbilical endometriosis and no recurrence during a one-year follow-up. This study concludes that primary umbilical endometriosis should be a primary differential diagnosis for umbilical masses presenting with cyclic bleeding. Its practical contribution emphasizes integrating imaging with histopathological confirmation as the gold standard, highlighting wide excision as a definitive therapeutic modality for optimal clinical outcomes and prevention of recurrence]]>
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