A Case of Sister Mary Joseph's Nodule

Masashi Tsuruta, Hirotoshi Hasegawa, Hideki Nishibori, Yoshiyuki Ishii, Takashi Endo, Nobuhiro Nitori, Koji Okabayashi, Fumitaka Asahara, Makio Mukai* and Masaki Kitajima

Department of Surgery and Department of Pathology*, Keio University

A 70-year-old man presented with lower abdominal pain and a hard, 1.0-cm nodule on the upper edge of his umbilicus with a reddish appearance and tenderness. A physical examination showed an advanced carcinoma of the sigmoid colon with no other distant metastases, except for the umbilical one. The patient underwent a sigmoid colectomy and resection of the umbilical tumor. Histopathological examination revealed an umbilical metastasis of a moderately differentiated adenocarcinoma of the sigmoid colon. An umbilical metastasis from an internal malignancy is known as a Sister Mary Joseph nodule (SMJN) and has a very poor prognosis. Most studies show a survival period from the time of diagnosis of less than one year. On the other hand, some reports have concluded that aggressive surgery may improve survival. The possibility of umbilical metastasis from an intra-abdominal malignancy must be kept in mind when an umbilical nodule is encountered.

Key words
Sister Mary Joseph's nodule, umbilical metastasis, colon cancer

Reprint requests
Hirotoshi Hasegawa Department of Surgery, Keio University
35 Shinanomachi, Shinjyuku-ku, 160-8582 JAPAN

Accepted
September 27, 2006

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