Cholangicarcinoma Presenting as a Sister Mary Joseph Nodule

Premkumar, Madhumita; Rangegowda, Devaraja; Vyas, Tanmay; Grover, S.; Joshi, Yogendra; Sharma, Chhagan Bihari; Sahney, Amrish

doi:10.14309/crj.2016.52

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…5,10 Dr. Mayo subsequently studied these tumors and published an article about Gastrointestinal malignancies account for about half of the underlying pathologies, and men are more likely to have an underlying cancer of the gastrointestinal tract. 7 Similarly, gynecological cancers account for about 1 in 4 cases. 4 Appearance of the Sister Mary Joseph nodules is a metastatic sign of an internal malignancy and can therefore indicate advanced primary disease and poorer prognosis.…”

Section: Discussionmentioning

confidence: 99%

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Benign Umbilical Tumors Resembling Sister Mary Joseph Nodule

Yang

Shin

et al. 2021

Clin Med Insights Oncol

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Background: When physicians see an umbilical nodule, most of them instinctively recall the Sister Mary Joseph nodule. Therefore, dermatologists need to recognize umbilical dermatoses that can be mistaken for the Sister Mary Joseph nodules. This study aimed to describe the different kinds of benign umbilical tumors as well as elucidate the factors that can be used to distinguish the Sister Mary Joseph nodule from these tumors. Methods: The “benign umbilical tumor” group included 19 patients, whereas the “Sister Mary Joseph nodule” group comprised 30 patients (2 from our department, 28 from PubMed search). We compared the clinical and dermoscopic findings between 2 groups. Results: In the “benign umbilical tumor” group, the most common diagnosis was dermatofibroma (5/19), followed by keloid (3/19), and soft fibroma (3/19). These tumors had various colors (red, brown to black, and flesh colored) and exhibit characteristic surface changes (eg, verrucous changes in epidermal nevi and verrucae). Conversely, most Sister Mary Joseph nodules have an erythematous color, oozing or ulceration on the surface, and nearby satellite lesions. Furthermore, the dermoscopic findings of Sister Mary Joseph nodules showed a polymorphous vascular pattern and a white or milky-red, amorphous area. Benign lesions showed different dermoscopic patterns: pigment networks with white areas (dermatofibromas), thrombosed capillaries (verrucae), and the “pore sign” (epidermal cysts). Conclusions: Various cutaneous tumors can be mistaken for the Sister Mary Joseph nodule when they develop on the umbilicus; the clinical and dermoscopic differences found in this study may be useful for establishing a differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

“…The “benign umbilical tumor” group comprised 19 patients. The “Sister Mary Joseph nodule” group consisted of 30 patients: 2 from our department and 28 from a PubMed search using the keyword “Sister Mary Joseph nodule [title].” 4 - 25 …”

Section: Methodsmentioning

confidence: 99%

Benign Umbilical Tumors Resembling Sister Mary Joseph Nodule

Yang

Shin

et al. 2021

Clin Med Insights Oncol

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“…It is commonly associated with gastric, colonic, pancreatic, ovarian, uterine malignancies, and even lymphomas. Hematogenous spread and spread along the obliterated umbilical vein, or along falciform ligament, median umbilical ligament, and along the umbilical duct remnant are proposed modes of spread for the umbilical nodule [ 13 ]. It could be a sign of extensive metastatic disease and usually predicts a survival of 10-12 months [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…A few cases of cholangiocarcinoma presenting as SMJ nodule have previously been described, though to the best of our knowledge, only one of them has been reported in the post-liver transplant setting [ 13 - 15 ].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Cholangiocarcinoma Presenting as Sister Mary Joseph Nodule After Liver Transplantation

Muppidi¹,

Meegada²,

Eason³

et al. 2020

Cureus

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Hilar cholangiocarcinoma, also known as Klatskin tumor, is the most common type of cholangiocarcinoma. It usually has a lymphatic spread and is rarely associated with an umbilical nodule, also known as Sister Mary Joseph nodule. We report a case of a 53-year-old Caucasian man with hilar cholangiocarcinoma. The patient had an inoperable tumor and was referred to our center for liver transplantation. Post liver transplantation, the patient presented with a recurrence of the carcinoma in the umbilical region. The patient was found to have Sister Mary Joseph nodule. It carries a poor prognosis, and our patient succumbed to the illness in four months. Cholangiocarcinoma carries a poor prognosis. Surgical resection and liver transplantation with neoadjuvant chemoradiation are the preferred treatment strategies. Association of cholangiocarcinoma with umbilical metastasis is rare, and our patient had an even rarer presentation in the form of recurrence with umbilical nodule post-liver transplantation. We want to increase the awareness of the rare presentation, association, and recurrence of hilar cholangiocarcinoma in the form of umbilical nodule post-liver transplantation.

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“…Then, umbilical nodules have been described in various cancers, but the association with cholangiocarcinoma is rare 1. Sister Mary Joseph’s nodule revealing intrahepatic cholangiocarcinoma without other symptoms is exceedingly uncommon 2. It may be caused by a propagation through lymphatic, venous or arterial ducts, through the ligaments of embryological origin or by a contiguous extension 3.…”

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confidence: 99%