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A 66-year-old diabetic woman was admitted for an abdominal nodule that had been evolving for 6 months. Clinical examination found an isolated umbilical nodule of 3.5 cm without any other symptoms or signs (figure 1A). Abdominal CT showed a left hypodense hepatic nodule. Liver function tests were normal. The plasma level of CA-19-9 was elevated at 13150 IU/mL. Abdominal MRI revealed a left intrahepatic mass measuring 49×58 mm (figure 2).
Contributors WBK idea writing, TB revision, AK revision.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.