An 80-year-old man, with a past medical history of ictus and chronic ischemic heart disease, sought medical attention for an umbilical cutaneous lesion (Fig. 1) of 8-month progression. It was considered omphalitis and treated topically with no clinical response. Given its persistence, the skin lesion was biopsied and the anatomopathologic study reported infiltration due to adenocarcinoma of colorectal origin.

Figure 1.

Umbilical cutaneous metastasis.

A fiberoptic colonoscopy examination found a stenosing lesion at 30cm from anal margin consistent with adenocarcinoma, confirming the origin of the cutaneous metastasis. Peritoneal and bilateral adrenal and lung metastases were identified in the extension CT scan.

Given the advanced stage IV disease with no possible curative treatment, the multidisciplinary committee agreed upon endoscopic placement of a stent over the sigmoid lesion, as shown in Fig. 2A and B. Palliative chemotherapy was administered and the patient died 4 months after the definitive diagnosis was made.

Figure 2.

Stenosing sigmoid tumor with palliative stent. A) Coronal view of the abdominal CT scan, showing the stent placed over the tumor in the sigmoid colon. B) Axial view of the abdominal CT scan, showing the umbilical metastasis.