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Umbilical Complications of Malignancy

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Abstract

Introduction

Cancer patients may manifest a variety of intraabdominal complications occurring during various phases of their illness; however, little in the literature exists regarding umbilical abnormalities in this population.

Discussion

Umbilical metastases (Sister Mary Joseph’s sign) are the most common malignant complication involving the umbilicus and may be the presenting manifestation of visceral malignancy. Cancer patients may occasionally experience periumbilical ecchymosis (Cullen’s sign), infection, hernia, or varices, each of which may require therapy. This review succinctly presents several umbilical complications that the clinician may encounter in patients with malignant disease.

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References

  1. Marinella MA. Small and large bowel obstruction. In: Handbook of cancer emergencies. Sudbury, Massachusettes: Jones and Bartlett Publishers, in press.

  2. Das AK, Higgins A, Fildes J. Sister Joseph’s node. Age Ageing 2008;37:349. doi:10.1093/ageing/afn020.

    Article  PubMed  Google Scholar 

  3. Healy JC, Barley NR. Surface anatomy of the abdomen and pelvis. In Gray’s anatomy. The anatomical basis of clinical practice. 39rd ed. Philadelphia: Elsevier Churchill Livingstone; 2005. p. 1097–100.

    Google Scholar 

  4. Netter F. Abdomen. In: Atlas of Human Anatomy. Summit, NJ: Ciba-Geigy Corporation, 1989, plate 236

  5. McBurney C. Experience with early operative interference in cases of disease of the vermiform appendix. N Y State Med J 1889;50:676.

    Google Scholar 

  6. Jaffe BM, Berger DH. The appendix. In: Brunicardi FC, Andersen DK, Billiar TR, et al, editors. Schwartz’s principles of surgery. 8th ed. New York: McGraw-Hill; 2005. p. 1119–37.

    Google Scholar 

  7. Steck WD, Helwig EB. Tumors of the umbilicus. Cancer 1965;18:907–15. doi:10.1002/1097-0142(196507)18:7<907::AID-CNCR2820180721>3.0.CO;2-U.

    Article  PubMed  CAS  Google Scholar 

  8. Powell FC, Cooper AJ, Massa MC, Goellner JR, Su WP. Leiomyosarcoma of the small intestine metastatic to the umbilicus. Arch Dermatol 1984;120:402–3. doi:10.1001/archderm.120.3.402.

    Article  PubMed  CAS  Google Scholar 

  9. Dodiuk-Gad R, Ziv M, Loven D, et al. Sister Mary Joseph’s nodule as a presenting sign of internal malignancy. Skinmed 2006;5:25–258. doi:10.1111/j.1540-9740.2006.04826.x.

    Article  Google Scholar 

  10. Behtash N, Mehrdad N, Shamshirsaz A, Hashemi R, Amouzegar HF. Umbilical metastasis in cervical cancer. Arch Gynecol Obstet 2008;278:489–91. Apr 1.

    Article  PubMed  Google Scholar 

  11. Burcheri S, Arcaini L. A paraumbilical lymphomatous mass. Eur J Haematol 2006;77:180. doi:10.1111/j.1600-0609.2006.00680.x.

    Article  PubMed  Google Scholar 

  12. Chagpar A, Carter JW. Lymphoma presenting as a Sister Mary Joseph’s nodule. Am Surg 1998;64:799–800.

    PubMed  CAS  Google Scholar 

  13. Tam C, Turner H, Hicks RJ, Seymour JF. Diffuse large B-cell non-Hodgkin’s lymphoma presenting as Sister Josephs’s nodule. Leuk Lymphoma 2002;43:2055–7. doi:10.1080/1042819021000016005.

    Article  PubMed  CAS  Google Scholar 

  14. Khan AJ, Cook B. Metastatic carcinoma of umbilicus: “Sister Mary Joseph’s nodule. Cutis 1997;60:297–8.

    PubMed  CAS  Google Scholar 

  15. Beynet D, Oro AE. Leukemia cutis presenting as a Sister Mary Joseph nodule. Arch Dermatol 2004;140:1170–1. doi:10.1001/archderm.140.9.1170.

    Article  PubMed  Google Scholar 

  16. Handa U, Garg K, Mohan H. Fine-needle aspiration cytology of Sister Mary Joseph’s (paraumbilical) nodules. Diagn Cytopathol 2008;36:348–50. doi:10.1002/dc.20817.

    Article  PubMed  Google Scholar 

  17. Alnaqbi KAY, Joshi S, Ghazal-Aswad S, Abu Zidan FM. Primary umbilical adenocarcinoma. Singapore Med J 2007;48:e308–10.

    PubMed  CAS  Google Scholar 

  18. Ross JE, Hill RB. Primary umbilical adenocarcinoma. A case report and review of literature. Arch Pathol 1975;99:327–9.

    PubMed  CAS  Google Scholar 

  19. Alver O, Ersoy YE, Dogusoy G, Erguney S. Primary umbilical adenocarcinoma: case report and review of the literature. Am Surg 2007;73:923–5.

    PubMed  Google Scholar 

  20. Etter L, Cook JL. Basal cell carcinoma of the umbilicus: a case report and literature review. Cutis 2003;71:123–6.

    PubMed  Google Scholar 

  21. Tsiouris A, Ahmed HA, Kumar N, Kaisary A. Urachal tumor: clinical and radiological features of a poorly differentiated carcinoma. Ann R Coll Surg Engl 2007;89:88–9. doi:10.1308/147870807X227764.

    Article  Google Scholar 

  22. Morii A, Furuya Y, Fujiuchi Y, et al. Urachal signet ring cell carcinoma. Int J Urol 2007;14:360–1. doi:10.1111/j.1442-2042.2007.01676.x.

    Article  PubMed  Google Scholar 

  23. Herr HW, Bochner BH, Sharp D, Dalbagni G, Reuter VE. Urachal carcinoma: contemporary surgical outcomes. J Urol 2007;178:74–8. doi:10.1016/j.juro.2007.03.022.

    Article  PubMed  Google Scholar 

  24. Garcia Figueiras R, Diaz Tie M, Lapena Villarroya JA. Port site metastases after laparoscopic cholecystectomy for an unexpected gallbladder carcinoma. Abdom Imaging 1999;24:404–6.

    Article  PubMed  CAS  Google Scholar 

  25. Ciulla A, Romeo G, Genova G, Tomasello G, Agnello G, Cstronovo G. Gallbladder carcinoma late metastases and incisional hernia at umbilical port site after laparoscopic cholecystectomy. G Chir 2006;27:214–6.

    PubMed  CAS  Google Scholar 

  26. Nally C, Preshaw RM. Tumour implantation at umbilicus after laparoscopic cholecystectomy for unsuspected gallbladder carcinoma. Can J Surg 1994;37:243–4.

    PubMed  CAS  Google Scholar 

  27. Mabin TA, Gelfand M. Cullen’s sign, a feature in liver disease. Br Med J 1974;1 5906:493–4.

    Article  PubMed  CAS  Google Scholar 

  28. Marinella MA, Baumann M. Cullen’s sign associated with metastatic esophageal carcinoma. J Hosp Med 2008;3:277–8. doi:10.1002/jhm.300.

    Article  PubMed  Google Scholar 

  29. Marinella MA. Cullen’s sign associated with metastatic thyroid cancer. N Engl J Med 1999;340:149–50. doi:10.1056/NEJM199901143400214.

    Article  PubMed  CAS  Google Scholar 

  30. Silvestre JF, Jover R, Betlloch I, Carnicer F, Banuls J, Perez-Mateo M. Cullen’s sign secondary to intraabdominal non-Hodgkin’s lymphoma. Am J Gastroenterol 1996;91:1040–1.

    PubMed  CAS  Google Scholar 

  31. Fajobi O, Jafri Z, Vadgama N, Cannon E, Myint F. Retroperitoneal non-Hodgkin’s lymphoma presenting as periumbilical erythema. J Am Acad Dermatol 2005;53:527–8. doi:10.1016/j.jaad.2005.01.118.

    Article  PubMed  Google Scholar 

  32. Cohen PR. Community-acquired methicillin-resistant Staphylococcus aureus skin infection presenting as periumbilical folliculitis. Cutis 2006;77:229–32.

    PubMed  Google Scholar 

  33. Voitk AJ, Tsao SG. The umbilicus in laparoscopic surgery. Surg Endosc 2001;15:878–81. doi:10.1007/s00464-001-0002-x.

    Article  PubMed  CAS  Google Scholar 

  34. Mayol J, Garcia-Aguilar J, Ortiz-Oshiro E, De-Diego Carmona JA, Fernandez-Represa JA. Risks of the minimal access approach for laparoscopic surgery: multivariate analysis of morbidity related to umbilical trocar insertion. World J Surg 1997;21:529–33. doi:10.1007/PL00012281.

    Article  PubMed  CAS  Google Scholar 

  35. Khati NJ, Enquist EG, Javitt MC. Imaging of the umbilicus and periumbilical region. Radiographics 1998;18:413–31.

    PubMed  CAS  Google Scholar 

  36. Forrest JV, Stanley RJ. Transverse colon in adult umbilical hernia. AJR 1978;130:57–9.

    PubMed  CAS  Google Scholar 

  37. Millar RC, Geelhoed GW, Ketcham AS. Ovarian cancer presenting as umbilical hernia. J Surg Oncol 1975;7:493–6. doi:10.1002/jso.2930070609.

    Article  PubMed  CAS  Google Scholar 

  38. Ginsburg BY, Sharma AN. Spontaneous rupture of an umbilical hernia with evisceration. J Emerg Med 2006;30:155–7. doi:10.1016/j.jemermed.2005.05.017.

    Article  PubMed  Google Scholar 

  39. Chan MY, Ng BK. Intrahernial tumour—a case report. Singapore Med J 1994;35:646–7.

    PubMed  CAS  Google Scholar 

  40. Heisterkamp J, Halm JA, Tilanus HW, Metselaar HJ, Kazemier G. Another patient with an umbilical hernia and massive ascites: what to do. Surgery 2007;142:372–5. doi:10.1016/j.surg.2007.05.006.

    Article  PubMed  Google Scholar 

  41. Yang PM, Chen DS. Caput Medusae. N Engl J Med 2005;353:e19. doi:10.1056/NEJMicm050651.

    Article  PubMed  Google Scholar 

  42. Sherlock S, Dooley J. The portal venous system and portal hypertension. In Diseases of the liver and biliary system. 11th ed. Oxford, UK: Blackwell; 2002. p. 147–86.

    Google Scholar 

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Correspondence to Mark A. Marinella.

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Marinella, M.A. Umbilical Complications of Malignancy. J Gastrointest Canc 39, 37–41 (2008). https://doi.org/10.1007/s12029-008-9046-7

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  • DOI: https://doi.org/10.1007/s12029-008-9046-7

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