This Weeks Medical Challenge

It's time again to test your diagnostic skill with the New England Journal of Medicine image challenge. (click on the image to see up close)   The nodule formed in this young woman in the umbilical (naval) area and bled intermittently.  What is the diagnosis?

1.  Endometrioma
2.  Metastatic adenocarcinoma
3.  Omphalith
4.  Umbilical hernia
5.  Urachal cyst

Give me your best answer as a comment and I will post the answer with fascinating learning points tomorrow.


Dr. Know said…
I think it is #2 metastatic carcinoma. Great images and I like this blog
DO said…
Hmmm...Urachal cyst. I want to see it drain urine...
KM said…
I think it is #2 Metastatic adenocarcinoma
Dr Paula said…
Endometrioma. The key is "intermittent bleeding"
Doccory said…
Endometroma: young, female, intermittant bleeding.
abnormalfacies said…
I have to go with metastatic carcinoma.

Bleeding, yes, but the fact that there's no mention of its relation to the menstrual cycle (or pain) allows me to rank endometrioma lower than a met to that famous node that shall not be named.
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It won't succeed as a matter of fact, that's what I believe.
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Anonymous said…
What medical treatment that needs with this?

Mine is bleeding. Please advise.

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