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Article
June 1977

Pancreatic Carcinoma With Dissemination to Umbilicus and Skin

Author Affiliations

From the Gastrointestinal Section, Department of Medicine (Drs Chakraborty, Reddy, and Grosberg), and the Department of Surgery (Dr Wapnick), Veterans Administration Hospital, Brooklyn, NY, and State University of New York Downstate Medical Center, Brooklyn.

Arch Dermatol. 1977;113(6):838-839. doi:10.1001/archderm.1977.01640060134021
Abstract

Careful examination of the umbilical area may at times yield unexpected clues to the diagnosis and the pathologic origin of intra-abdominal disease. Metastases from the pancreas may implant on the umbilicus. The mode of distribution of umbilical and paraumbilical implants in our patient with pancreatic carcinoma was most eye-compelling, and forms the substance of this report.

Report of a Case.—  A 62-year-old man was admitted to the hospital for shortness of breath and for swelling of the abdomen and legs. Results of physical examination were consistent with congestive heart failure. In addition, a firm, irregular, 3 × 4-cm node adherent to the overlying skin was palpable in the right axilla.The abdomen was distended; shifting dullness and fluid wave were present. On digital examination, a rectal shelf was felt. The umbilicus was protuberant and was preempted by a nodular, tender, bluishpink mass that was irregular in contour and outline. Distributed

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