Can a suspicious-looking mole in the umbilicus (belly button) be associated with palpable lymphadenopathy (lymph nodes) in the neck and elbow regions?

From the Guidelines

A suspicious-looking mole in the umbilicus can be associated with palpable lymphadenopathy in the neck and elbow regions, as melanoma can metastasize to distant lymph nodes, and this situation requires prompt medical evaluation with a dermatologist or oncologist for proper diagnosis. The primary drainage of the umbilical region is to the axillary and inguinal lymph nodes, but melanoma cells can travel through the lymphatic system and bloodstream to reach distant sites, such as the neck and elbow regions 1.

Key Considerations

• The pattern of spread of melanoma does not follow predictable anatomical pathways, making it possible for lymph nodes in the neck and elbow to be affected by a mole in the umbilicus.
• Enlarged lymph nodes in the neck and elbow can be caused by various conditions, including metastatic disease, infection, and inflammation, and a thorough evaluation is necessary to determine the underlying cause.
• A biopsy of the mole and possibly imaging studies or lymph node sampling may be necessary to determine if there is a connection between the mole and the enlarged lymph nodes.

Evaluation and Management

• The evaluation of a neck mass in adults should consider characteristics suspicious for malignancy, such as the absence of infectious etiology, mass present for 2 weeks or of uncertain duration, reduced mobility of the neck mass, firm texture of the mass, neck mass size > 1.5 cm, and ulceration of the skin overlying the neck mass 1.
• The management of incidental findings on thoracic CT, including mediastinal and cardiovascular findings, should consider the size, texture, and distribution of the nodes, as well as the clinical history and symptoms of the patient 1.
• The assessment of lymph nodes should be done by clinical examination and ultrasound, supplemented by ultrasound-guided fine needle aspiration or core biopsy of suspicious lymph nodes, and additional investigations such as chest CT, abdominal ultrasound or CT scan, and bone scan should be considered for patients with clinically positive axillary nodes, large tumors, or aggressive biology 1.

From the Research

Association between Suspicious-Looking Mole and Lymphadenopathy

• There is no direct evidence in the provided studies to suggest a link between a suspicious-looking mole in the umbilicus (belly button) and palpable lymphadenopathy (lymph nodes) in the neck and elbow regions.
• The studies primarily focus on metastatic disease in various types of cancer, such as colorectal cancer 2, 3, 4, 5 and breast cancer 6, but do not specifically address the relationship between a mole in the umbilicus and lymphadenopathy.
• The studies discuss the use of imaging techniques, such as whole-body MRI and PET/CT, for diagnosing and staging metastatic disease, but do not provide information on the association between a suspicious-looking mole and lymphadenopathy.

Imaging Techniques for Metastatic Disease

• Whole-body MRI has been shown to be effective in identifying metastatic disease in colorectal cancer patients 4, 5.
• Other imaging techniques, such as CT, PET/CT, and MRI, are also used in the diagnosis and staging of metastatic disease in various types of cancer 2, 3, 6.
• The choice of imaging technique depends on the type of cancer, the location of the metastases, and the patient's overall health.

Limitations of the Studies

• The studies provided do not address the specific question of whether a suspicious-looking mole in the umbilicus can be associated with palpable lymphadenopathy in the neck and elbow regions.
• The studies focus on metastatic disease in various types of cancer, but do not provide information on the relationship between a mole in the umbilicus and lymphadenopathy.