A Case of Umbilical Metastasis from an Intrahepatic Cholangiocarcinoma

Abstract

A 53-year-old woman presented to our hospital with black stools, a 20-mm hard umbilical nodule, and body weight loss. Computed tomography revealed an intrahepatic cholangiocarcinoma with peritoneal dissemination and invasion into the portal vein, common bile duct, gallbladder, and pancreas. Endoscopic clipping for gastric varices was necessary. She died 3 months after her initial visit. One hundred seventy patients with malignant umbilical metastases, including our own case, have been reported in Japan since 1978. Forty-three patients were male ; the others were female. The mean age was 64.0±14.0 years. The primary tumors were located in the ovary, stomach, and pancreas in descending order of prevalence. Intrahepatic cholangiocarcinoma was only detected in 2 cases, including our case. The median time to death from the diagnosis of umbilical metastasis was 10.7±11.1 months. The prognosis varied according to the primary malignancy, but was basically poor. Physicians should therefore consider the prognosis when the decision is made to resect an umbilical metastasis due to such factors as exudate fluid and malodor.