PMC3636959_01
a First biopsy from the umbilicus showing a malignant melanoma with a tumor thickness of 3 mm and Clark's level IV (HE. x5). b The arrow points to the mitosis of tumor cells (HE. x40).
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F1
The Breslow depth was estimated at 3 mm, Clark's level was IV (fig. 1a) and tumor mitotic rate  6 mitoses/mm2 (fig. 1b).
a An irregular incision was made with lateral margins >2 cm from the original scar (indicated by an arrow). b Gross view of the specimen, including the umbilicus, round ligament of the liver (ligamentus rotundus) and urachus. c Incision site after reconstruction.
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F2
A wide, irregular reexcision was subsequently performed with lateral margins >2 cm (fig. 2a) from the original scar down to the peritoneum, including the umbilicus, round ligament of the liver and urachus (fig. 2b). We concluded the procedure by closing the abdominal cavity and incision directly (fig. 2c).