TY  - JOUR
T1  - IMage of the month—quiz case
AU  - Genders RE, Bonsing BA, van der Molen A, Lavrijsen S
Y1  - 2011/03/01
N1  - 10.1001/archsurg.2011.24-a
JO  - Archives of Surgery
SP  - 361
EP  - 361
VL  - 146
IS  - 3
N2  - 
A 60-year-old man presented to the Department of Dermatology with an 8-month history of recurrent infections of the umbilicus. The umbilicus was intermittently treated by the general practitioner with a topical antibiotic and an antiseptic. There was no reaction to therapy, and the patient's umbilicus had slowly grown larger. The patient disclosed that he also had complained of mild bowel problems since the preceding year and that these problems were referred to as irritable bowel syndrome. There was no history of trauma, former bowel disorders, or malignant neoplasms. He also denied a family history of similar diseases. Results of a physical examination revealed a firm red and blue, multinodular tumor of 2 cm that protruded through the umbilicus (Figure 1). The deeper parts were covered with slough and yellow debris. Around the umbilicus, at the upper right quadrant, a 3- to 4-cm induration of the skin of the abdominal wall was palpated. Physical examination of the abdomen revealed no abnormalities. A skin biopsy specimen was taken from the central part of the umbilical tumor. Routine hematological and biochemical blood test results were normal.

SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2011.24-a
UR  - http://dx.doi.org/10.1001/archsurg.2011.24-a
ER  -