Periumbilical mass--what can cause this?
Category: Health > Conditions and Diseases
Asked by: oedipamassive-ga
List Price: $10.00
20 Jul 2006 16:12 PDT
Expires: 19 Aug 2006 16:12 PDT
Question ID: 748143
Greetings. I am only asking this question here because my regular doctor is out of town for several days, and the physician covering her caseload was not very helpful at all. Question summary: I have an unexplained firm mass protruding from my belly, and while I'm waiting for my medical care professionals to get back to me with test results and referrals and such, it would really help my peace of mind to get some independent info on what could possibly be causing such a phenomenon. The background info: I am a 50-year-old woman, obese, but in the midst of a medically-supervised weight loss regimen run by my HMO. I have lost 60 pounds since the end of January, and in the process I have revealed a sizeable, relatively firm mass protruding from my belly, which apparently had been previously camoflaged by fat. The mass is fairly symmetrical, centered around and slightly above my navel; about 6 inches in diameter and protruding a couple of inches from the surrounding flesh. It seems to be in the fat tissue itself--i.e., outside the wall of my abdominal muscles. There is hardly ever any pain associated with this mass, except for a couple of months ago where it almost felt like I had a muscle pull in the abdominal muscles around and under the mass. In fact, it felt for all the world like I had strained my belly button, if such a thing is poassible. This pain took a couple of days to resolve, but otherwise there's been nothing. After reporting the problem to my regular physician--who thought it might be a hernia--I underwent an abdominal CT scan earlier this week, and a bunch of bloodwork a couple of weeks ago. The substitute doctor was dreadfully unhelpful in explaining what the CT scan meant (she wasn't looking at the scan itself, just reading a text report from the techs who performed it) and refused to speculate on what the mass might be, except to say something rather confusing to me about fibroids, which I thought only occurred within the uterus. The sub-doctor did tell me that all of my bloodwork was absolutely normal, including a blood test that can flag for possible cancer activity. I do have referrals in process to GYN and surgery specialists for further examination and biopsy, and my regular physician gets back late next week, but in the meantime I would really like to get some more helpful information on what this mass might possibly be--especially, things it could be other than cancer, which would be really reassuring to know. I am aware that *unexplained* weight loss is a strong symptom of cancer. However, I have been *deliberately* working on weight loss through a program of my HMO, and have been losing at a relatively normal rate of 2.5 pounds a week (on a nutritionally balanced plan), and I've proven to myself that if I don't stick to the plan my weight loss does stop, so I'm relatively sure I don't have to worry on that score. Also, I have generally been feeling pretty healthy--not tired or run-down in any way; in fact, due to the weight loss I've been able to enjoy greater physical activity and some light exercise. I do suffer from other health conditions, some of which might have something to do with the unexplained mass, some of which probably have nothing to do with it, but I'll list them anyway, just for thoroughness' sake. These conditions include: GERD; hypertension; gout; osteoarthritis; hemmorrhoids/anal fissure with occasional bleeding (bright red blood). Other medical history details which may or may not have to do with things: I have no personal history of cancer, though my mother did die of breast cancer. I am well into perimenopause, and have never borne children. My periods, when they happen, tend to be heavy, with flooding and profound cramps, but as of now I haven't been diagnosed with fibroids. I do not take (and would like to avoid taking) hormone replacement therapy. So--forgive the long data dump, but that's everything I can think of right now that might be pertinent to my problem. Any help would be vastly appreciated.
Re: Periumbilical mass--what can cause this?
Answered By: crabcakes-ga on 20 Jul 2006 21:04 PDT
Hello Oedipamassive, I can understand your apprehension at the appearance of this mass. Be aware that we can?t diagnose you online, but can only provide some information about periumbilical masses. This list is not a comprehensive list, as there causes numerous to numerous to liast that ?could? fit your description. This is a list of some possibilities, ranging from the ?simply benign? to the more serious type of malady. I certainly hope in your case that you suffer from a benign cause. ?An abdominal mass can be a sign of an abscess, a problem with a blood vessel (such as an aneurysm), an enlarged organ (such as the liver, spleen, or kidney), a tumor, or an accumulation of feces.? Many of these do not fit your description, but some do. ? Abdominal aortic aneurysm can cause a pulsating mass around the navel. ? Bladder distention (urinary bladder over-filled with fluid) can cause a firm mass in the center of the lower abdomen above the pelvic bones, and in extreme cases can extend as far up as the navel. ? Cholecystitis can cause a very tender mass that is felt below the liver in the right-upper quadrant (occasionally). ? Colon cancer can cause a mass almost anywhere in the abdomen. ? Crohn's disease or bowel obstruction can cause multiple tender, sausage-shaped masses anywhere in the abdomen. ? Diverticulitis can cause a mass that is usually located in the left-lower quadrant. ? Gallbladder tumor can cause a moderately tender, irregularly shaped right-upper quadrant mass. ? Hydronephrosis (fluid-filled kidney) can cause a smooth, spongy-feeling mass in one or both sides or toward the back (flank area). ? Kidney cancer can sometimes cause a mass in the abdomen. ? Liver cancer can cause a firm, lumpy mass in the right upper quadrant. ? Liver enlargement (hepatomegaly) can cause a firm, irregular mass below the right rib cage (right costal margin), or on the left side in the stomach area (epigastric). ? Neuroblastoma, a malignant tumor often found in the lower abdomen, that primarily occurs in children and infants. ? Ovarian cyst can cause a smooth, rounded, rubbery mass above the pelvis in the lower abdomen. ? Pancreatic abscess can cause a mass in the upper abdomen in the epigastric area. ? Pancreatic pseudocyst can cause a lumpy mass in the upper abdomen in the epigastric area. ? Renal cell carcinoma can cause a smooth, firm, nontender mass near the kidney (usually only affects one kidney). ? Spleen enlargement (splenomegaly) -- the edge of an enlarged spleen may sometimes be felt in the left-upper quadrant. ? Stomach cancer can cause a mass in the left-upper abdomen in the stomach area (epigastric) if the cancer is large. ? Uterine leiomyoma (fibroids) can cause a round, lumpy mass above the pelvis in the lower abdomen (occasionally can be felt if the fibroids are large). ? Volvulus can cause a mass anywhere in the abdomen. ? Ureteropelvic junction obstruction can cause a mass in the lower abdomen. http://www.nlm.nih.gov/medlineplus/ency/article/003274.htm Umbilical Hernia ================ ?An umbilical hernia appears in the belly button. A periumbilical hernia is similar to an umbilical hernia, but occurs next to the belly button. A person with a hernia often feels pain, pressure or burning, or a feeling that something has given way.? http://www.webmd.com/hw/health_guide_atoz/sth149784.asp Periumbilical Hernia http://www.vandenberg.af.mil/~MDG/handouts/Pg224.pdf Hepatic Lesion ============== ?The ligamentum teres hepatis (edit: Also called falciform ligament)connects the umbilicus to the left lobe of the liver, and thus a hepatic lesion can spread through the ligament to the umbilicus and the anterior abdominal wall. We present a case of hepatoma of the left lobe which extended to the rectus abdominis muscle through the ligamentum teres.? http://www.springerlink.com/(vuhwt3jwrfasq02vmccixez2)/app/home/contribution.asp?referrer=parent&backto=issue,24,83;journal,88,97;linkingpublicationresults,1:100116,1 Illustrations http://www.fotosearch.com/illustration/falciform-ligament.html Sister Mary Joseph Nodules ========================== ?Sister Mary Joseph nodules are metastatic deposits in the periumbilical area. The purpose of this review is to demonstrate umbilical anatomy, discuss modes of metastatic spread, the various imaging appearances and their relevance to the radiologist.? http://bjr.birjournals.org/cgi/content/abstract/72/864/1230 ?Sister Mary Joseph first noticed that a 'nodule' in the umbilicus was often associated with advanced malignancy. She drew William James Mayo?s attention to this sign and he published an article about it in 1928, referring to is as the "pants button umbilicus". In 1949 the English surgeon Hamilton Bailey (1894-1961), in his famous textbook "Physical Signs in Clinical Surgery", in 1949 coined the term "Sister Joseph's nodule" for an umbilical metastasis.? http://www.whonamedit.com/doctor.cfm/2984.html I wish I could tell you more. Try to be patient and relaxed while you wait for your doctor to review all your test results to get a clear clinical picture of your problem. Congratulations on your weight loss! I personally know how hard that is! I wish you the best! If anything is unclear, please request an Answer Clarification, and allow me to respond, before you rate. Sincerely, Crabcakes Search Terms ============= Periumbilical mass Abdominal mass
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