Sister Mary Joseph's nodules are commonly associated with internal malignancies. It usually manifests as a nodule with an irregular border around umbilicus, however, it may present as blue–black, friable, ulcerated lump with drainage as large as 10 cm. Sister Mary Joseph's nodules has a poor prognosis with average survival time of 11 months. We report an 85-year-old female presenting with painless, erythematous nodules on the umbilicus that developed over one month. Histopathology findings of skin biopsy was consistent with metastatic adenocarcinoma. Computerized tomography imaging of abdomen and pelvic showed a large pelvic mass obstructing the sigmoid colon. The patient was subsequently managed by a multidisciplinary surgical and medical oncology team.
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