Sister Mary Joseph Nodule and Concomitant Pancreatitis as Initial Presentation of Pancreatic Adenocarcinoma – Case Report and Review of the Literature

Abstract

Umbilical metastasis [Sister Mary Joseph Nodule (SMJN)] is a rare presentation of visceral abdominal/pelvic malignancy. It is less commonly seen in metastatic pancreatic adenocarcinoma and there are only over a hundred cases to date in the literature on this topic. This article highlights a case of metastatic pancreatic adenocarcinoma presenting as SMJN and concomitant pancreatitis (which to the best of our knowledge is the first such report to date) with discussions regarding the etiopathogenesis of this phenomenon and presents a brief literature review on pancreatic adenocarcinoma presenting as SMJN.

Sister Mary Joseph Nodule (SMJN) – A Review

“…The nodule may appear normal skin coloured, whitish, bluish violet, darkish or brownish red [46] as shown in Figures 1 and 2. The surface of the nodule may appear fissured and ulcerated (Figure 2) and a sanguineous, mucinous, serous, or purulent secretions may also be discharged [47]. Gallbladder crusts or scales in a 52-year-old previously diagnosed case of advanced stage of an adenocarcinoma of the stomach [48].…”

Sister Marie-Joseph's Nodule Revealing A Pancreatic Adenocarcinoma: About A Case with Review of the Literature

“…It was described by Sister Marie-Joseph Dempsey, an operating nurse at William J. Mayo in Rochester, Minnesota [3]. Pancreatic cancer accounts for 7-9% of reported cases of Sister Mary Joseph's nodule, with nearly 90% of tumors occurring in the body and tail of the pancreas [4]. We report the case of a patient with SMJ nodule as the initial clinical presentation of pancreatic cancer.…”