Sister Mary Joseph Nodule as a First Manifestation of a Meta
1. Introduction
Sister Mary Joseph nodule (SMJN) is a rare umbilical lesion resulting from an intra-abdominal and/or pelvic malignancy. It was named after Sister Mary Joseph, a surgical assistant to Dr. William J. Mayo, who noted the association between the presence of an umbilical nodule and an intra-abdominal malignancy. Its incidence is 1%–3% of all intra-abdominal or pelvic malignancies. Gastrointestinal malignancies, most commonly gastric, colon, and pancreatic, account for about 52% of cases and gynecological cancers, most commonly ovarian and uterine, account for about 28% of the underlying sources. Also, 15–29% of all cases have an unknown origin. The mechanism of tumor spread to the umbilicus is poorly understand as it seems to be lymphatic, vascular, contiguous, or via embryologic remnants in the abdominal wall.

2. Case Presentation
A 76-year-old female with a one-month history of a rapidly enlarging and friable umbilical tumor presented to our hospital for a surgery consult. She had a past history of hypertension, hyperlipidemia, and tubal ligation. Her family history was not relevant. Physical examination showed a 2?cm firm, nontender, protuberant umbilical nodule (Figure 1). She was diagnosed with telangiectatic granuloma and received treatment with topical antibiotics; however, after two months no improvement was noted....
Dr. S●●●●●a A●●●●●l and 3 others like this
Dr. H●●●●h D●●●i
Dr. H●●●●h D●●●i Obstetrics and Gynaecology
SMJN may be the late phenomenon at least for ovarian cancer. Now a days with routine use of trans vaginal sonography & other imagimg modalities ovarian cancer are gradually being diagnosed earlier .
Feb 6, 2017Like