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June 2006

A Dermal Nodule Near a Laparotomy Scar—Quiz Case

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Arch Dermatol. 2006;142(6):775-780. doi:10.1001/archderm.142.6.775-d

A 55-year-old man presented with a 7-year history of a bluish nodule at the periumbilical area, near a laparotomy scar. The nodule had slowly enlarged over a 1-year period and was slightly tender. The laparotomy had been performed for rectal polyps 26 years earlier.

Physical examination revealed a 1-cm, bluish gray, slightly elevated nodule at the left side of the umbilicus, next to a 10-cm laparotomy scar (Figure 1). The nodule was deep-seated, firm, and tender on palpation. The lesion was completely excised. During the procedure, a metal wire was found connected to the nodule. The wire was removed, and the tissue specimen was sent for microscopic examination (Figure 2 and Figure 3).