Basal Cell Carcinoma of the Umbilicus: A Comprehensive Literature Review

Abstract

Basal cell carcinoma (BCC) typically occurs in sun-exposed sites. Only 16 individuals with umbilical BCC have been described in the literature, and the characteristics of patients with umbilical BCC are summarized. PubMed was used to search the following terms: abdomen, basal cell carcinoma, basal cell nevus syndrome, and umbilicus. Papers with these terms and references cited within these papers were reviewed. BCC of the umbilicus has been reported in five men and 11 women; one man had two tumors. Two patients had basal cell nevus syndrome (BCNS). Other risk factors for BCC were absent. The tumor most commonly demonstrated nodular histology (64%, 9/14); superficial and fibroepithelioma of Pinkus variants were noted in three and two patients, respectively. The tumor was pigmented in eight individuals. Treatment was conventional surgical excision (87%, 13/15) or Mohs micrographic surgery (13%, 2/15); either adjuvant laser ablation or radiotherapy was performed in two patients. The prognosis after treatment was excellent with no recurrence or metastasis (100%, 16/16). In conclusion, BCC of the umbilicus is rare. It usually presents as a tumor with a non-aggressive histologic subtype in an individual with no risk factors for this malignancy. There has been no recurrence or metastasis following excision of the cancer.

Keywords: basal cell carcinoma; umbilicus.

Figure 1. Umbilical basal cell carcinoma (BCC) presenting as a pigmented plaque

Distant (A) and closer (B) views of an umbilical BCC presenting as a pigmented plaque measuring 3.0 x 1.5 cm on the umbilicus of a 50-year-old, Fitzpatrick skin type 5, African-American woman who presented for routine skin examination.

Figure 2. Umbilicus punch biopsy histology

Low (A) and higher (B and C) magnification views of a 3 mm punch biopsy of the umbilical plaque in the woman from Figure 1. Microscopic examination showed nodular aggregates of basaloid tumor cells extending from the epidermis into the dermis (A). In the tumor and surrounding stroma, there were deposits of melanin, some of which were present in melanophages (B and C). Mucin, with or without melanin-containing melanophages, is present within the tumor aggregates (C). (hematoxylin and eosin stain: a = x4, b = x10, c = x40).