PERCUTANEOUS cryoablation may offer a minimally invasive treatment option for umbilical endometriosis, with new data suggesting the technique can substantially reduce pain and lesion volume while delivering favourable cosmetic outcomes.1
Umbilical endometriosis is an uncommon form of cutaneous endometriosis in which endometrial-like tissue develops in or around the umbilicus. The condition, sometimes referred to as Villar’s nodule, can present as a discoloured skin lesion accompanied by cyclical pain, swelling or bleeding linked to hormonal changes during the menstrual cycle.2 Surgical excision is currently used for treatment, but less invasive alternatives with established safety and efficacy remain limited.1
Minimally Invasive Approach Shows Promising Outcomes
Researchers evaluated the safety and feasibility of image-guided percutaneous cryoablation in 17 women treated for umbilical endometriosis at a single institution between 2017 and 2024.1 The median age of participants was 38 years.
Cryoablation procedures were performed using ultrasound guidance alone or combined ultrasound and CT guidance. Most procedures (70%) were undertaken under general anaesthesia, while 94% were completed on an outpatient basis.
At a median follow-up of 22 months, complete pain relief was reported in 82% of patients. Median peak pain scores on the visual analogue scale fell from 8.0 before treatment to 0.0 after treatment, representing a statistically significant (p < 0.001) reduction.1
Imaging findings also suggested marked improvements following the intervention. Median nodule volume on MRI decreased from 2.98 cm³ before treatment to 0.90 cm³ afterwards, representing a median individual reduction of 73%.1
Cosmetic Results May Support Patient Satisfaction
More than 80% of patients reported being satisfied or very satisfied with the cosmetic outcome following treatment.1 This is important, as umbilical endometriosis may not only lead to disabling pain, but may also cause visible cosmetic concerns which may influence quality of life and treatment decisions.
Adverse Events Highlight Need for Caution
Although the findings support the feasibility of cryoablation, adverse events were recorded in three patients. Two were classified as minor superficial frostbite injuries, while one patient required surgical debridement following a major complication.1 Further information on any pre-existing conditions in the patients with adverse reactions would therefore be useful to help clinicians decide who is suitable for the procedure.
The study was limited by its small sample size and single-centre design, meaning larger studies will be needed to confirm long-term safety and effectiveness. However, the data suggest image-guided cryoablation could emerge as a less invasive alternative for selected patients with umbilical endometriosis who may wish to avoid surgery.
References
- De Rycke A et al. Percutaneous image-guided cryoablation of umbilical endometriosis: safety, feasibility, clinical, and imaging outcomes. Eur Radiol. 2026;DOI:10.1007/s00330-026-12592-7.
- Sharma A et al. Cutaneous endometriosis (2025) Treasure Island: StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK560918/. Last accessed 13 May 2026.
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