Differential Diagnosis for a 31-year-old with Unusual Belly Button Mole, On and Off Fullness under Left Ribs, and Palpable Left Elbow Lymph Nodes
- Single Most Likely Diagnosis
- Metastatic melanoma: The presence of an unusual belly button mole, which could be a primary melanoma, combined with symptoms suggestive of metastasis (fulness under the left ribs potentially indicating liver or spleen involvement and palpable lymph nodes) makes metastatic melanoma a strong consideration. The belly button (umbilicus) is an uncommon site for primary melanomas but can occur.
- Other Likely Diagnoses
- Lymphoma: The presence of palpable lymph nodes, particularly if they are painless, could suggest lymphoma. The fullness under the left ribs could be due to splenomegaly, which is sometimes seen in lymphoma.
- Hepatocellular carcinoma or other liver cancers with metastasis: Although less common in a 31-year-old without known risk factors, any abdominal fullness or discomfort could suggest liver pathology, and metastasis to lymph nodes could explain the elbow findings.
- Sarcoidosis: This condition can cause lymphadenopathy (enlarged lymph nodes) and could potentially cause abdominal symptoms if there is liver or spleen involvement. However, the unusual mole would not be directly explained by sarcoidosis.
- Do Not Miss Diagnoses
- Abdominal lymphoma with cutaneous manifestation: Some lymphomas can present with skin lesions that mimic moles, and the abdominal fullness could be due to lymphadenopathy or organ involvement.
- Metastatic cancer from an unknown primary: The presence of lymph node metastasis and an unusual mole could suggest a cancer of unknown primary origin, which is a condition where metastatic cancer is detected but the site of the primary cancer is not known.
- Rare Diagnoses
- Malignant blue nevus: A rare type of melanocytic lesion that can metastasize.
- Angiosarcoma: A rare and aggressive form of cancer that originates from the lining of blood vessels and can present with skin lesions and metastasis to lymph nodes and other organs.
- Kaposi's sarcoma: A rare cancer that forms in the lining of blood and lymph vessels and can cause skin lesions and lymphadenopathy, though it is more commonly associated with immunocompromised states.