A nodule bulging into umbilicus, into a patient who is losing weight and feels ill, may be due to a nodule of a metastatic tumour.
The presentation of an umbilical secondary tumour always indicates advanced, widespread disease and primary tumour commonly in the abdomen. The tumour cells reach the umbilicus via the lymphatics that run in the edge of the falciform ligament alongside the obliterated umbilical vein, or by transperitoneal spread. Umbilical metastases are usually associated with multiple peritoneal metastases.
Nodules of secondary carcinoma usually ulcerate, bleed and become infected,
Metastases at the umbilicus may become attached to and infiltrate the underlying bowel. Necrosis of the tumour tissue then causes an acquired umbilical-intestinal fistula.
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