FDG PET/CT Imaging of Calcified Sister Mary Joseph Nodule

Abstract

Sister Mary Joseph nodule (SMJN) refers to any metastatic deposit in the periumbilical region. Herein, we report a very rare case of calcified SMJN from ovarian papillary serous adenocarcinoma showing intense FDG uptake.

Calcified Sister Mary Joseph nodule as the presenting complaint of advanced low-grade serous ovarian cancer

“…Although calcified umbilical masses in the case of serous ovarian cancer have been previously reported by authors such as Inanir and Oksuzoglu [16] , and Evans et al. [17] , our case differs in several important aspects.…”

Sister Mary Joseph Nodule in Advanced Pancreatic Adenocarcinoma Identified on 18F-FDG PET/MRI

“…The tumor markers, including carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125, should be examined. The mechanism of tumor spread to the umbilicus has been postulated as direct invasion from the peritoneum through hematogenous or lymphatic pathways or along the embryonic remnants of the ligamentum teres or umbilical ligaments (3)(4). In addition to metastasis, the differential diagnosis of a neoplastic umbilical nodule includes primary carcinoma, endometriosis, hernia, and granuloma, among others (5).…”

Sister Mary Joseph Nodule (SMJN) – A Review

“…USG further offers an advantage of dynamically observing and guiding the needle throughout any biopsy process. In recent years, Fluorodeoxyglucose Positron Emission Tomography/ Computed Tomography FDG PET/CT and FDG PET/MRI have been reported as an innovative imaging tools in the identification of Sister Mary Joseph nodule by display of intense FDG uptake [52][53][54].…”