Clinicopathologic features and surgical management of primary umbilical XXXX : a case series.

@entity5 @entity1 @entity320 @entity3
BACKGROUND: Primary umbilical @entity320 is an uncommon @entity5 that is poorly described in the medical literature. The umbilical region is a particular anatomic site owing to the presence of embryonal remnants, which can be a potential metastatic pathway, as well as the braided lymphatic network drainage. Hence, primary @entity5 affecting the umbilicus require a different and more radical surgical approach compared with other @entity320 . CASE PRESENTATION: In this report, we describe a series of three @entity1 of Caucasian ethnicity who presented with primary umbilical @entity320 at the National @entity5 Institute of Naples, Italy. All @entity1 underwent wide excision of the @entity5 including the underlying peritoneum. No surgical complications, either immediate or delayed, were observed in any of the @entity1 . Sentinel lymph node biopsy was negative in two cases. Two of the @entity1 developed @entity3 and died after systemic medical therapy. The other @entity1 is currently in follow-up, and remains disease-free after 21 months. CONCLUSIONS: The umbilicus has vascular and embryological connections with the underlying peritoneum, so that early visceral involvement is more likely to occur with primary umbilical @entity320 . As such, @entity5 resection including the underlying peritoneum is required to avoid local relapse, whilst sentinel lymph node biopsy appears to be of poor diagnostic value.
