PMC5836228_01
Macroscopic image of the umbilical fossa. An induration of 15 x 10 mm in size that accompanied redness was present (arrows).
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F1
In the initial examination in our hospital, an induration of 15 mm x 10 mm in size that accompanied redness was palpable in the umbilical fossa (Fig. 1).
Skin tissue biopsy image of the umbilical fossa. Irregularly shaped nuclei of atypical cells with a nucleolus indicate poorly differentiated adenocarcinoma. Original magnification x200.
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F2
As a result, poorly differentiated adenocarcinoma was detected (Fig. 2).
Upper gastrointestinal endoscopic image. Borrmann type IV advanced gastric cancer was present in the anterior wall of the gastric corpus.
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F3
In upper gastrointestinal endoscopy conducted to identify the primary site, type IV advanced gastric cancer was observed in the anterior wall of the gastric corpus (Fig. 3).
Tissue biopsy image of Borrmann type IV advanced gastric cancer. In the histopathological biopsy of gastric cancer, poorly differentiated adenocarcinoma, which was similar to an umbilical mass, was detected. Original magnification x200.
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F4
Histopathological biopsy of the gastric cancer detected poorly differentiated adenocarcinoma, which was similar to the result of skin tissue biopsy of the umbilical fossa (Fig. 4).
a Contrast-enhanced computed tomography (CT) image of the abdomen. A high-density node in the umbilical area (arrow) and elevated peritoneal concentration reflecting peritoneal dissemination (arrowheads) were observed. b Plain CT image of the abdomen. After the start of chemotherapy, the umbilical node was reduced and peritoneal dissemination was improved.
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F5
Computed tomography performed for whole-body examination revealed a high-density node in the umbilical area and elevated peritoneal concentration reflecting peritoneal dissemination (Fig. 5a). As a result, SMJN was reduced and carcinomatous peritonitis was improved (Fig. 5b).