Sister Mary Joseph's nodule

Case of a Sister Mary Joseph's Nodule in a High Grade Serous Carcinoma

Sister Mary Joseph's nodule (SMJN) is a metastatic malignancy of the umbilicus usually indicative of advanced, metastatic disease. It is a rare occurrence, but it may be the first sign of abdominal cancer, most commonly an adenocarcinoma metastasis from a gastrointestinal or gynecologic primary malignancy. We present the case of an 82-year-old woman with an acute, 2 cm non-tender mass located at the umbilicus, diagnostic indication of an SMJN. Additional investigations included imaging via ultrasound and a pelvic magnetic resonance imaging (MRI) along with a biopsy and immunohistochemical staining in order to further characterize the mass. Our findings are discussed in the following case report.

Umbilical metastasis as primary manifestation of cancer: a small series and review of the literature

Umbilical metastasis is a rare manifestation of intra-abdominal cancer. It appears either as the first sign of a primary malignancy or as metastatic site of an already diagnosed cancer, representing an ominous prognostic finding. We report three cases of umbilical metastasis as the first sign of an underlying malignancy. Hypotheses about pathophysiology of umbilical metastasis are based on the embryological origin of the umbilicus and its residual communication with systematic, portal and lymphatic circulation.