Epidermotropic Metastatic Prostate Carcinoma Presenting as an Umbilical Nodule-Sister Mary Joseph Nodule

Abstract

Carcinoma of the prostate accounts for fewer than 1% of all skin metastases. Cutaneous metastases from prostate carcinoma most often involve the penis, the anterior aspect of the thighs, the suprapubic area, and the perineum, but they also have been reported in the scalp, the chest, the back, and even the face. We report an unusual case of metastatic prostate adenocarcinoma that presented as an umbilical nodule (Sister Mary Joseph nodule) and demonstrated significant epidermotropism histologically. A review of the literature has found only one documented case of prostatic carcinoma metastasizing to the umbilicus, and one other documented case of epidermotropic metastatic prostate carcinoma.

Sister Mary Joseph nodule as the presenting sign of disseminated prostate carcinoma

“…Other reported primary sites were the cecum, pancreas, gall bladder, fallopian tube, and endometrium, [1,8,10] and rarely from the lung and prostate. [1][2][3][4][5][6][7] SMJN as the initial manifestation of an internal malignancy has been reported in 14-45% cases in various series, [11] and case reports, [1,4,11] including secondaries originating from prostatic adenocarcinoma, [1][2][3][4][5][6][7] similar to the present case.…”

“…[13] Skin is an uncommon site, with prostate carcinoma accounting for less than 1% of all skin metastases. [4] The common areas for skin metastases include the penis, anterior aspect of the thighs, suprapubic area, and the perineum, with few cases reported in the scalp, chest, back, and even the face. [4] Umbilical involvement is rare, and has been reported in about seven cases only.…”

“…[4] The common areas for skin metastases include the penis, anterior aspect of the thighs, suprapubic area, and the perineum, with few cases reported in the scalp, chest, back, and even the face. [4] Umbilical involvement is rare, and has been reported in about seven cases only. [1][2][3][4][5][6][7] Of all the cases of cutaneous metastasis of prostate cancer reported in Japan, only three metastases have occurred in the umbilical region.…”

“…Most common sites of origin are in the gastrointestinal or genital tracts, while other locations are rare. [1][2][3][4][5][6][7][8] Prostate as a primary site has been reported in few case reports only. [1][2][3][4][5][6][7] We recently encountered a 76-year-old male who presented with umbilical nodule, which was subsequently diagnosed as a case of prostate carcinoma with extensive metastases.…”

Cutaneous metastases of visceral tumours: a review

“…6) (Koga et al 2000). Umbilical skin metastases, also referred to as "Sister Mary Joseph's nodules", were associated with ovarian cancer, but may also be aYliated with gastrointestinal malignancies or prostatic cancer (Fukuda and Saito 2006;Stanko et al 2007). Oesophageal, gastric and colonic cancers, cancers of biliary tract, pulmonary carcinomas and malignancies derived from renal cells preferred hairy scalp, neck, and face for a distant cutaneous spreading (Fruh et al 2005; Cutaneous metastases can be classiWed as loco-regional-, in-transit-or distant metastases.…”