Umbilical Sebaceous Cyst Mimicking Infected Urachal Sinus

In addition to the most likely diagnoses for umbilical signs in adults (umbilical hernia, metastatic tumour, endometriosis, congenital abnormalities such as umbilical-urachal sinus and gallstones retained or spilled at the umbilicus), the differential diagnosis should also include epidermoid cyst arising from the skin of the umbilicus. We describe the case of a young man who presented with a persistent umbilical discharge which was initially thought to be umbilical-urachal sinus, but later found to be a sebaceous cyst. LEARNING POINTS: Umbilical sebaceous cysts are rarebut should be included in the differential diagnosis in patients presenting with umbilical discharge, erythema, pain or a palpable mass. They should be considered even when the cystic lesion involves the white line, where remnants of embryonic structures are more likely, as they have been described both above and belowthe fascia, extending and penetrating the white line. Preoperative imaging including ultrasound as well as CT helps to differentiate between umbilical sebaceous cysts and urachal sinus, thusfacilitating adequate preoperative planning to ensure a better outcome.