Umbilical metastasis as a primary presentation in carcinoma
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The metastatic umbilical lesion, also known as Sister Mary Joseph nodule (SMJN) is secondary to a primary malignancy of any viscera. So far reported cases of SMJN can be categorized as metastatic from gastrointestinal malignancies (35–65%), genitourinary tract (12–35%), unknown sites (15–30%) and those from the lung and breast (3–6%). Depending on the characteristics of the primary tumor inside, it can be fissured or ulcerated and be secreting serous, mucinous, purulent or bloody discharge. Umbilical metastasis from intra-abdominal visceral malignancies is a form of SMJN. It can be a presenting feature of undiagnosed malignancy. A 39-year-old man presented with a two-month history of painful swelling over the umbilicus. On workup, the umbilical nodule was diagnosed as metastatic adenocarcinoma with a primary lesion in mid rectum.

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