[Umbilical metastasis of carcinoma of the gallbladder]

The case of a 60 year old woman with an umbilical nodule of sudden onset, followed one year later by cholestatic jaundice and weight loss, is reported. The histology of the nodule suggested a metastatic adenocarcinoma of undetermined origin. Laboratory and radiological investigations, abdominal echography and laparotomy disclosed carcinoma of the gallbladder with invasion of the main biliary duct and peritoneal dissemination. A biliodigestive derivation was found technically impossible at the surgical operation and the neoplastic disease far too advanced tu justify chemotherapy. Only eleven cases of biliary tract carcinoma with umbilical metastases could be found in the literature. The relative incidence of the primary tumors giving umbilical metastases, the different ways in which they can reach the umbilicus and the ominous meaning of these metastases are discussed and the relevant literature is reviewed.