Sister Mary Joseph Nodule as a First Manifestation of a Metastatic Ovarian Cancer

Calongos, Giannina; Ogino, Mai; Kinuta, Takatoshi; Hori, Masateru; Mori, Tatsuo

doi:10.1155/2016/1087513

Cited by 14 publications

(17 citation statements)

References 8 publications

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“…Umbilical nodular swelling can go unnoticed for several months before the diagnosis of malignancy. It is highly recommended that once discovered, such lesions should be worked up with biopsy and imaging studies such as ultrasound or CT of the abdomen as the nodule may be indicative of primary or secondary malignancy and cancer recurrence [ 5 , 6 ]. Upon discovery of umbilical lesion in our patient, she was also promptly evaluated with biopsy to determine metastasis.…”

Section: Discussionmentioning

confidence: 99%

Sister Mary Joseph’s Nodule: Where Umbilicus Holds the Truth!

Dhruv

Anwar

Polavarapu

et al. 2021

Cureus

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An umbilical metastasis from an internal visceral malignancy is defined as Sister Mary Joseph's nodule (SMJN), and, although a rare finding, it is a very poor prognostic indicator. We describe an interesting case of metastatic colon cancer with SMJN, emphasizing the significance of this classic finding. A 64-year-old female with a history of stage IV colon cancer with palliative right hemicolectomy and left hepatectomy presented to the hospital with nausea and abdominal discomfort. A computed tomography (CT) scan of the abdomen was performed, which showed small bowel obstruction secondary to metastatic tumor mass compressing the duodenum. She refused to undergo any chemotherapy or endoscopic intervention and was eventually discharged on hospice care. During the hospital stay an umbilical ulcerative lesion was also noted, which was violaceous, measuring 4.5 x 4 cm in size, firm in consistency with irregular borders, and tender to touch. Therefore, further history was obtained from the patient about it. Several months ago, she had developed localized swelling around the umbilicus, which gradually enlarged and ulcerated later. She eventually underwent the biopsy of that umbilical lesion, which confirmed it as SMJN with metastasis from the colonic primary. However, the patient refrained from the surgical intervention of the umbilical lesion. SMJN presents as a palpable periumbilical metastatic mass with diameter usually not exceeding 5 cm in size. It can be variable in color from violaceous to reddish brown. Once discovered, such lesions should be worked up with biopsy and imaging studies such as CT scan of the abdomen, as the nodule may be indicative of underlying malignancy or cancer recurrence. Its presence indicates a poor prognosis, with average survival time after diagnosis of SMJN of 10 months.

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Section: Discussionmentioning

confidence: 99%

Sister Mary Joseph’s Nodule: Where Umbilicus Holds the Truth!

Dhruv

Anwar

Polavarapu

et al. 2021

Cureus

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“…Benign conditions are umbilical hernia, granuloma, abscess, eczema, and mycosis. Malignant tumors can be either primary umbilical origin or metastatic [4]. On physical examination, its appearance is often misleading because skin overlying the lesion can be normal or erythematous [5].…”

Section: Discussionmentioning

confidence: 99%

“…Commonly encountered primary tumors are gastrointestinal malignancies including gastric, colonic, and pancreatic which account for 52% of cases. Gynecological cancers account for about 28% and the rest of the cases have an unknown origin [4]. The likelihood of SMJN presenting as an initial clinical feature and associated venous thromboembolism during the first encounter is extremely rare in the literature.…”

Section: Introductionmentioning

confidence: 99%

Abdominal Malignancy with Skin Manifestation and Thromboembolic Disease: An Unusual Presentation

Chandradevan¹,

Espinal²,

Shahid³

et al. 2020

Cureus

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A 55-year-old male presented to our hospital with shortness of breath and leg swelling. Imaging studies revealed deep vein thrombosis and bilateral pulmonary embolism. The patient was placed on anticoagulation. A palpable umbilical nodule consistent with the appearance of Sister Mary Joseph's nodule (SMJN) raised the possibility of an underlying gastrointestinal malignancy. The patient also had significant ascites and underwent paracentesis with cytology, upper gastrointestinal and lower gastrointestinal endoscopy with the biopsy. Gastric lesion histology revealed gastric adenocarcinoma with peritoneal and colonic metastases. The patient was started on chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX) for disseminated gastric malignancy. SMJN is a rare cutaneous metastatic manifestation which needs to be considered as a differential diagnosis of an umbilical tumor for prompt diagnosis and initiation of treatment.

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“…Other rare etiologies for SMJN such as lymphoma [10] , [11] , [12] , metastatic prostate cancer [13] , and renal cell carcinoma [14] have also been reported. SMJN heralds advanced stages of intra-abdominal malignancy, with mean life expectancy from 2 to 11 months without treatment and only 17.6 to 21 months with aggressive treatments combining surgical excision, radiotherapy, and chemotherapy [15] .…”

Section: Discussionmentioning

confidence: 99%

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

Yang

Kinloch

Martin

et al. 2020

Radiology Case Reports

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A healthy 38-year-old woman presented with a hard umbilical mass that has been growing for a few months in duration with no other significant symptoms and signs. Computed tomography images identified a lobulated densely calcified umbilical mass, left ovarian cysts, a subcentimeter calcified omental nodule, and nonspecific punctate pelvic calcifications. Histopathology of the mass revealed low-grade serous carcinoma with postsurgical diagnosis of International Federation of Gynecology and Obstetrics (FIGO) stage IV ovarian cancer. This case presentation emphasizes the importance of increased awareness of interpreting radiologists of a seemingly benign appearing imaging finding such as umbilical calcification on CT as a sign of intra-abdominal/pelvic malignancies.

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Sister Mary Joseph Nodule as a First Manifestation of a Metastatic Ovarian Cancer

Cited by 14 publications

References 8 publications

Sister Mary Joseph’s Nodule: Where Umbilicus Holds the Truth!

Sister Mary Joseph’s Nodule: Where Umbilicus Holds the Truth!

Abdominal Malignancy with Skin Manifestation and Thromboembolic Disease: An Unusual Presentation

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

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