Sister Mary Joseph nodule as the only sign of silent caecal adenocarcinoma

Abstract

Sister Mary Joseph nodule is a nodule localized in the umbilicus which represents a cutaneous metastasis from a primary cancer, mostly localized in the abdomen. We report the case of an 82-year-old woman who presented with an ulcerated umbilical nodule. Imaging identified it as a Sister Mary Joseph nodule, representing the only distant metastasis from a silent caecal adenocarcinoma. When an umbilical nodule is found at clinical examination imaging can play a crucial role in determining underlying pathology and in determining therapeutic strategy.

Sister Mary Joseph Nodule (SMJN) – A Review

“…Subsequent laparotomy had confirmed endometrial carcinoma metastasizing to the umbilical region [22]. Caulo et al have reported a case of an 82-year-old woman who presented with an ulcerated umbilical nodule which on evaluation was identified as a SMJN, representing the only distant metastasis from a silent caecal adenocarcinoma [23]. Munoz et al reported a 44-yearold female with poorly differentiated malignant neoplasm involving ovaries, whose clinical presentation was progressive abdominal distension which she had attributed to pregnancy and a tumour protruding through her umbilical area that was oozing serosanguinous fluid [24].…”