Expansion
A metastatic nodule at the umbilicus, spreading along the ligamentum teres or peritoneal fluid
Expansion
The umbilicus is a uniquely accessible point for intra-abdominal tumour because several routes converge there:
- Ligamentum teres - carrying tumour directly from the liver or along the falciform ligament
- Peritoneal (transcoelomic) spread, since the umbilicus is a thin point of the wall
- Lymphatic channels of the anterior abdominal wall
- Embryological remnants - the obliterated urachus and vitelline vessels
The commonest primaries are gastric, pancreatic, ovarian and colorectal.
It is named after Sister Mary Joseph Dempsey, surgical assistant to William Mayo, who noticed the association.
Companion signs of advanced abdominal malignancy worth grouping with it: Virchow’s node (left supraclavicular), Krukenberg tumour (ovarian deposits) and Blumer’s shelf (rectovesical pouch deposits palpable on rectal examination).