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Gynaecological malignancies frequently metastasize to contiguous structures, internal organs and bones. Cutaneous metastasis as a primary or recurrent presentation of these malignancies is rare and only a few cases have been reported in the literature. A twenty year (1991-2010) retrospective search for umbilical metastasis from gynaecological malignancies in our departmental case records showed only four cases. Four post-menopausal females presented with painful cutaneous umbilical (Sister Joseph's) nodules. The clinical examinations of all four patients revealed well delineated nodules of varying sizes and degrees of ulceration. Other findings were matted axillary and inguinal lymph node enlargement, intra-abdominal and pelvic masses, vaginal discharge and vaginal bleeding. Incisional tissue biopsies from the nodules were processed in paraffin wax and stained with haematoxylin and eosin. Histology of the sections showed pigmented skin overlying metastatic malignant tumours consistent with adenocarcinoma from the endometrium and ovary in three cases, and squamous cell carcinoma, large cell keratinizing from the cervix uteri in the fourth case. Gynaecological cancers have a global spread and varied geographic distribution. Cervical cancer is the commonest in our setting and patients often present to hospital with advanced stage disease. Ovarian and endometrial cancers are infrequent and their diagnosis may be delayed by non- specificity of presenting clinical symptoms from other benign tumours at these sites. Although umbilical metastasis is commonly associated with gastro-intestinal malignancies, its presence may be the first harbinger of occult gynaecologic cancer.

Objective: Ruptured ectopic gestation is a life threatening medical emergency especially in developing countries. However, the occurrence of hydatidiform mole in ruptured tubal pregnancy is uncommon., Material and Methods: A consecutive analysis of patients with hydatidiform mole in ruptured tubal gestation over a 9-year period in a tertiary hospital., Results: Of a total of 101 females with ectopic gestations, only five had ruptured tubal hydatidiform mole. The ages ranged from 20-37years and they all presented with acute abdominal symptoms which necessitated emergency surgical intervention. Intra-operative findings revealed ruptured/ leaking tubal gestation. The excised tissue specimens showed hydatidiform mole characterized by circumferential trophoblastic proliferation, hydropic degeneration and stromal karyorrhexis. Patients' serial HCG levels were monitored before discharge., Conclusion: Ruptured tubal hydatidiform mole is uncommon and strict histologic criteria are important in diagnosis. Serial HCG levels must be monitored in individual patients to forestall development of malignant trophoblastic disease.