Primary umbilical melanoma

We report a 72-year-old woman who presented with a primary melanoma of the umbilicus and periumbilical skin of 4 years' duration. Pathological examination of a biopsy specimen showed Clark's level IV, and tumour thickness 2.3 mm. The patient underwent preoperative lymphatic mapping followed by sentinel lymph node biopsy, and wide local excision of the primary tumour, including its attachment to the peritoneum. Because of the variations in vascularity and the residual embryonal connections of the umbilicus with the peritoneum and other intra-abdominal organs, an aggressive surgical approach is recommended in the management of malignant umbilical tumours.