Visceral neoplasia presenting at the umbilicus

An umbilical mass as the presenting and only symptom of an underlying visceral carcinoma is an infrequent occurrence. The implications of such a finding are illustrated by four examples, with primary tumors in pancreas, colon, and ovary. Adenocarcinoma in the umbilicus represents a metastatic deposit until proved otherwise. Further diagnostic evaluation to localize the primary tumor should be based upon therapeutic implications. The need for abdominal exploration must be individualized.