Basal Cell Carcinoma Invading the Umbilical Stalk Excised with Mohs Micrographic Surgery: Case Report and Review of Umbilical Anatomy

Surgical management of umbilical basal cell carcinoma: Published work review and the optimal depth of surgical excision

“…Although information about several reported cases was not available, the literature review revealed that the tumor size in each case was relatively small (range, 0.4–2.7 cm), and that nodular BCC was the most frequent histological type (Table ). Only one case had BCC involvement of the umbilical scar . In most cases, including ours, the BCC cells did not seem to invade into the umbilical scar, and the deepest invasion levels of tumor cells were up to the middle layer of the subcutaneous tissue.…”

“…BCC arising from the umbilicus is extremely rare and only nine cases have been reported (Table ) . In general, a history of skin trauma, surgical procedure, or chronic inflammation can predispose a patient to the development of BCC .…”

“…This fibrous scar penetrates the linea alba through the annulus umbilicalis. The transversalis fascia lies deep to the linea alba and just superficial to the peritoneum, which forms the floor of the umbilicus . This unique anatomy of the umbilicus and its close proximity to various anatomical structures may facilitate tumor spread into the abdominal cavity.…”

“…BCC arising from the umbilicus is extremely rare and only nine cases have been reported (Table 1). [3][4][5][6][7][8][9][10] In general, a history of skin trauma, surgical procedure, or chronic inflammation can predispose a patient to the development of BCC. 9 The findings for some of the reported umbilical BCC included association of an epidermal inclusion cyst, 3 simultaneous occurrence of lymphoma, 10 and a surgical scar caused by laparoscopy.…”

“…The transversalis fascia lies deep to the linea alba and just superficial to the peritoneum, which forms the floor of the umbilicus. 8 This unique anatomy of the umbilicus and its close proximity to various anatomical structures may facilitate tumor spread into the abdominal cavity. The deep invasion of the tumor cells into the umbilical scar and the anatomic proximity to the peritoneum can sometimes require aggressive surgical management to achieve tumor-free margin.…”