Umbilical Adenocarcinoma: When a Belly Button Becomes a Battleground

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"Discover how recurrent sweat gland umbilical adenocarcinoma is treated with wide excision and reconstruction surgery combined with chemotherapy to prevent recurrence."

Adenocarcinoma found in the umbilicus is an exceedingly rare occurrence. Most often, when cancer appears in this region, it's due to secondary events—metastasis from another primary site. However, in even rarer instances, the cancer originates from the sweat glands located in the umbilicus itself, presenting unique challenges due to its resistance to radiation and unpredictable clinical appearance.

Recently, a case study detailed the experience of a 37-year-old woman who faced recurrent umbilical adenocarcinoma. Her journey involved previous tumor surgery followed by chemotherapy. The cancer's return prompted an aggressive treatment strategy that offers insights into managing this rare condition.

This article delves into the specifics of this case, exploring the diagnostic approaches, surgical techniques, and the role of chemotherapy in preventing recurrence. By examining this instance, we aim to shed light on the complexities of treating sweat gland umbilical adenocarcinoma and the potential for improved outcomes.

The Case: Recurrence and the Road to Reconstruction

The patient's ordeal began when she noticed a painless nodule in her umbilicus. A prior surgery, 14 months before, confirmed moderately-differentiated adenocarcinoma. Despite undergoing six cycles of oral chemotherapy with Capecitabine, the tumor recurred, highlighting the aggressive nature of this cancer. The recurrence prompted a more comprehensive diagnostic and therapeutic approach.

Diagnostic tests, including a Fine Needle Aspiration Biopsy (FNAB), confirmed the presence of malignant cells. A colonoscopy ruled out the possibility of the tumor being a secondary metastasis from the colon. The results of the CT scan revealed no distant metastasis. The surgical team then proceeded with a wide excision surgery, removing the tumor along with a 5 cm margin of surrounding tissue. This procedure left a significant 17 cm defect on the anterior abdominal wall, necessitating reconstructive surgery.

Surgical Strategy: The surgical team's decisions were guided by a thorough review of the patient's previous pathological reports.
Goal of Surgery: Complete removal of the tumor, ensuring that both the gross and microscopic margins were free of cancerous cells.
Margin: Aimed to achieve a wide margin during the excision to minimize the risk of recurrence.

The reconstruction involved using an anti-adhesive Parietex polyester mesh, measuring 30 x 30 cm, to repair the abdominal wall defect. Histopathology of the excised tissue confirmed the diagnosis of sudoriferous gland adenocarcinoma, with no tumor cells found in the adjacent tissues. The patient then continued additional chemotherapy with Capecitabine and Bevacizumab. Six months post-surgery, a Positron Emission Tomography (PET) scan showed no signs of residual tumor or lymphadenopathy. Two years after surgery, the patient remains in remission, demonstrating the success of the treatment strategy.

A Promising Path Forward

This case underscores the potential of combining wide excision and reconstructive surgery with adjuvant chemotherapy to effectively manage recurrent sweat gland umbilical adenocarcinoma. The aggressive surgical approach, coupled with systemic therapy, offers a chance at long-term remission and improved quality of life for patients facing this rare and challenging condition.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1186/s12893-018-0421-4, Alternate LINK

Title: Wide Excision And Reconstruction Surgery For Recurrent Sweat Gland Umbilical Adenocarcinoma Followed By Chemotherapy Can Prevent The Risk Of Recurrences

Subject: General Medicine

Journal: BMC Surgery

Publisher: Springer Science and Business Media LLC

Authors: Adeodatus Yuda Handaya, Nova Yuli Prasetyo Budi, Guntur Marganing Adi Nugroho, Aditya Rifqi Fauzi

Published: 2018-10-12

Everything You Need To Know

What is umbilical adenocarcinoma, and why is it considered rare?

Umbilical adenocarcinoma is a very rare type of cancer. It originates in the umbilicus, which is the belly button. What makes it rare is that it often appears not as a primary cancer but as a result of metastasis from a different primary cancer site elsewhere in the body. In even rarer instances, the cancer, specifically sweat gland umbilical adenocarcinoma, begins in the sweat glands within the umbilicus itself. This rarity presents unique challenges in diagnosis and treatment, making each case a significant study in cancer management.

What are the typical treatment approaches for sweat gland umbilical adenocarcinoma?

Based on the described case, the treatment involves a combination of wide excision and reconstruction surgery, followed by chemotherapy. The wide excision surgery aims to completely remove the tumor, including a margin of surrounding tissue to reduce the risk of recurrence. Following surgery, chemotherapy, such as Capecitabine and Bevacizumab, is often administered to eliminate any remaining cancer cells and prevent the tumor from returning. The specific case discussed also highlights the use of diagnostic tools like Fine Needle Aspiration Biopsy (FNAB), colonoscopy, and CT scans to assess the extent of the cancer before surgery.

Why is wide excision surgery necessary in treating sweat gland umbilical adenocarcinoma?

Wide excision surgery is crucial because the goal is to completely remove the tumor and any potentially cancerous cells. This aggressive approach aims to achieve both gross and microscopic margins free of cancerous cells, meaning that when the tissue is examined under a microscope, no cancer cells are found at the edges of the removed tissue. This reduces the likelihood of the cancer returning or spreading to other parts of the body. The surgery typically involves removing the tumor along with a margin of healthy tissue around it, as done in the case of the 37-year-old woman where a 5 cm margin was used.

What role does chemotherapy play in the treatment of umbilical adenocarcinoma?

Chemotherapy plays a vital role in managing sweat gland umbilical adenocarcinoma, particularly after surgery. It serves as an adjuvant therapy, meaning it's used to help prevent the cancer from returning. The chemotherapy drugs Capecitabine and Bevacizumab, were used in the case. This systemic treatment targets any cancer cells that might remain after the surgery or that have spread to other parts of the body, reducing the chances of recurrence. This is particularly important with this type of cancer, which can be aggressive.

What are the key takeaways from the case study presented regarding the treatment of umbilical adenocarcinoma?

The case study underscores the potential of a combined approach for treating recurrent sweat gland umbilical adenocarcinoma. The success of this treatment strategy lies in the combination of wide excision and reconstructive surgery, followed by adjuvant chemotherapy. The case highlights the importance of thorough diagnostics, including FNAB, colonoscopy and CT scans, to assess the extent of the cancer. Furthermore, the patient's journey shows that the aggressive surgical approach coupled with systemic therapy, offers a chance at long-term remission and improved quality of life, particularly for patients dealing with this challenging condition. The two years post-surgery with no signs of the tumor indicate the effectiveness of this treatment strategy.