F 55, obese, polypoid mass from the base of umbilicus

    A 55-year-old obese white American woman of European descent presented with a 4-month history of slightly hemorrhagic discharge from her umbilicus. There was no history of fever, abdominal pain or any other systemic disease. Physical examination revealed a deep umbilicus with a barely visible opening. There was no redness, edema, or crusting of the periumbilical skin. The deeper aspect of the umbilicus was exposed by using a spatula. A dark, rounded polypoid mass was noted. The clinical impression was that of fibro-epithelial polyp or some other tumor. An attempt was made to remove the mass by excising the base; however, the mass easily came out of the umbilical cavity implying that either it was necrotic or it was not firmly attached to the umbilical tissue at the base. The gray-tan 0.8 cm size round mass on cut section revealed white fibrous appearance.