A Case of Sigmoid Colon Cancer with Sister Mary Joseph's Nodule

Ryutaro Sakabe, Yukio Sato, Naoki Hirabayashi, Wataru Takiyama, Yoshie Kobayashi, Minoru Kameoka, Akira Nakashima, Shuji Saeki, Hidenori Mukaida and Yoshinori Yamashita

Department of Surgery, Hiroshima City Asa Hospital

Metastatic umbilical tumor from internal malignancy, called Sister Mary Joseph's Nodule (SMJN), is known as a poor prognostic sign. SMJN from colorectal cancer is comparatively rare with only 37 cases reported, to our knowledge, in Japan. We report a case of sigmoid colon cancer with SMJN and review the clinical and pathological features of SMJN from colorectal cancer in the Japanese literature. A 54-year-old man admitted for abdominal pain and constipation was found in colonoscopy to have a sigmoid colon tumor with severe stenosis. Microscopic findings of the biopsy specimen showed well differentiated adenocarcinoma. Physical examination showed a hard red umbilical tumor 2 cm in diameter, and aspiration biopsy cytology showed metastatic adenocarcinoma. Abdominal computed tomography showed an enhanced mass at the umbilicus, with ascites and peritoneal dissemination. Operative findings showed sigmoid colon cancer with panperitonitis carcinomatosa and multiple liver metastases. The man underwent colostomy and systemic chemotherapy, but died of cancer 4 months after surgery. It is important to choose treatments for SMJN from colorectal cancer in consideration of the other organ metastases.

Key words
Sister Mary Joseph's Nodule, metastatic umbilical tumor, colon cancer

Reprint requests
Ryutaro Sakabe Department of Surgery, Hiroshima City Asa Hospital
2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293 JAPAN

Accepted
May 30, 2007

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