A 57-year-old Caucasian male was examined by his primary care physician for a 2-week history of an umbilical mass. On examination, the patient was noted to have an incarcerated umbilical hernia and was referred to a general surgeon for further evaluation. The patient was very active until several weeks prior, participating in soccer. He had a prior past medical history of hypertension, hypercholesterolemia, and gas-troesophageal reflux disease. He had no prior surgeries, no family history of malignancies, no smoking history, and drank alcohol only occasionally. He reported normal bowel movements and denied genitourinary complaints. After a general surgeon confirmed the diagnosis of an incarcerated umbilical hernia, the patient underwent open surgical repair. Intraoperatively, the hernia sac was excised and approximately 700 mL of straw-colored ascites was evacuated from the abdominal cavity. Cytology from the ascites revealed malignant cells.
展开▼
