Sister Mary Joseph’s Nodule as a Presenting Sign of Recurrent Gastric Carcinoma: A Case Report and Literature Review
Keywords:
gastric carcinoma, Sister Mary Joseph’s nodule, umbilicusAbstract
Sister Mary Joseph’s nodule (SMJN) is an uncommon manifestation of advanced gastric carcinoma, but
it is a very important and interesting clinical sign with rich history. The presence of SMJN often indicates
advanced intra-abdominal/pelvic malignancies. The ease of identifying this nodule emphasizes the importance
of thorough and careful examination of the umbilicus. We herein report a case of patient presenting with SMJN
as the first sign of recurrent gastric carcinoma. She received palliative surgical resection of the recurrent
tumors. This case is reported in order to emphasize the need for thorough examination of any umbilical lesion
in patient with advanced gastric carcinoma.
References
1. Al-Mashat F, Sibiany AM. Sister Mary Joseph’s nodule of the
umbilicus: is it always of gastric origin? A review of eight
cases at different sites of origin. Indian J Cancer 2010;47:65-
9.
2. Lookingbill D, Spangler N, Sexton FM. Skin involvement as
the presenting sign of internal carcinoma. A retrospective
study of 7316 cancer patients. J Am Acad Dermatol 1990;22:
19-26.
3. Nakamura M, Tamura J, Takaki R, et al. Sister Mary Joseph’s
nodule. Intern Med 2009;48:1775.
4. Khan AJ, Cook B. Metastaic carcinoma of umbilicus: “Sister
Mary Joseph’s nodule”. Cutis 1997;60:297-8.
5. Dubreuil A, Dompmartin A, Barjot P, et al. Umbilical metastasis
or Sister Mary Joseph’s nodule. Int J Dermatol 1998;37:7-13.
6. Zadeh VB, Kadyan R, Al-Abdulrazzaq A, et al. Sister Mary
Joseph’s nodule: a case of umbilical cutaneous metastasis
with signet ring cell histology. Indian J Dermatol Venereol
Leprol 2009;75:503-5.
7. Shen Z, Yang X, Chen L, et al. Sister Mary Joseph’s nodule as
a diagnostic clue to metastatic colon carcinoma. J Clin
Oncol 2009;27:e1-2.
8. Gabriele R, Conte M, Egidi F, et al. Umbilical metastases:
current viewpoint. World J Surg Oncol 2005;3:13.
9. Yendluri V, Centeno B, Springett G. Pancreatic cancer
presenting as a Sister Mary Joseph’s nodule: case report
and update of the literature. Pancreas 2007;34:161-4.
10. Lin CC, Liu KL, Lin JT, et al. Education and imaging.
Gastrointestinal: Sister Mary Joseph nodule. J Gastroenterol
Hepatol 2008;23:1462.
11. Abu-Hilal M, Newman JS. Sister Mary Joseph and her
nodule: historical and clinical perspective. Am J Med Sci
2009;337:271-3.
12. Piura B. Umbilical metastasis:Sister Mary Joseph’s nodule.
Harefuah 2006;145:505-9.
13. Barrow MV. Metastatic tumors of the umbilicus. J Chronic
Dis. 1966;19:1113-7.
14. Steensma DP. Sister (Mary) Joseph’s nodule. Ann Intern
Med 2000;133:237.
15. Albano EA, Kanter J. Sister Mary Joseph’s nodule. N Engl J
Med 2005;352:1913.
16. Bailey H. Demonstration of physical signs in clinical surgery,
11th ed. Baltimore: Williams & Wilkins; 1949. p. 227.
17. Powell FC, Cooper AJ, Massa MC, et al. Sister Joseph’s
nodule: a clinical and histologic study. J Am Acad Derm
1984;10:610-5.
18. Lee CK, Chang YW, Jung SH, et al. A case of Sister Mary
Joseph’s nodule as a presenting sign of gastric cancer.
Korean J Gastroenterol 2008;51:132-6.
19. Whang TB, Wang L, Peng DH. Gastric carcinoma of the
umbilicus: case report of Sister Mary Joseph nodule. Cutis
2010;85:90-2.
20. Sina B, Deng A. Umbilical metastasis from prostate carcinoma
(Sister Mary Joseph’s nodule): a case report and review of
literature. J Cutan Pathol 2007;34:581-3.
21. Limmathurotsakul D, Rerknimitr P, Korkij W, et al. Metastatic
mucinous cystic adenocarcinoma of the pancreas
presenting as Sister Mary Joseph’s nodule. JOP 2007;8:344-
9.
22. Baratta A, Gorin RJ, Costa R. Sister Mary Joseph nodule:a
case report. Cutis 2007;80:469-72.
23. Clague JE. Sister Joseph’s nodule. Postgrad Med J 2002;
78:174.
24. Gabriele R, Borghese M, Conte M, et al. Sister Mary Joseph’s
nodule as a first sign of cancer of the cecum: report of a
case. Dis Colon Rectum 2004;47:115-7.
25. Wu YY, Xing CG, Jiang JX, et al. Carcinoma of the right side
colon accompanied by Sister Mary Joseph’s nodule and
inguinal nodal metastases: a case report and literature
review. Chin J Cancer 2010;29:239-41.
26. Hopton BP, Wyatt JI, Ambrose NS. A case of Sister Mary
Joseph nodule associated with primary gastric lymphoma.
Ann R Coll Surg Engl 2005;87:W6-7.
27. Renner R, Sticherling M. Sister Mary Joseph’s nodule as a
metastasis of gallbladder carcinoma. Int J Dermatol 2007;
46:505-7.
28. Hodkinson HJ, Kew MC. Sister Joseph’s nodule in
hepatocellular carcinoma. Eur J Gastroenterol Hepatol
2001;13:865-7.
29. Liu CY, Yong CC, Wu SC, et al. Sister Mary Joseph’s nodule
associated with hepatocellular carcinoma. Surgery 2010;
147:167-8.
30. Fukuda H, Saito R. A case of Sister Mary Joseph’s nodule
from prostatic cancer. J Dermatol 2006;33:46-51.
31. Deb P, Rai RS, Rai R, et al. Sister Mary Joseph nodule as the
presenting sign of disseminated prostate carcinoma. J
Cancer Res Ther 2009;5:127-9.
32. Piura B, Meirovitz M, Bayme M, et al. Sister Mary Joseph’s
nodule originating from endometrial carcinoma incidentally
detected during surgery for an umbilical hernia: a case
report. Arch Gynecol Obstet 2006;274:385-8.
33. Behtash N, Mehrdad N, Shamshirsaz A, et al. Umblical
metastasis in cervical cancer. Arch Gynecol Obstet 2008;
278:489-91.
34. Wijekoon NS, Samarasekera DN. Sister Mary Joseph’s nodule
as the sole presenting feature of disseminated squamous
cell cancer of the esophagus: a rare case. J Gastrointest
Cancer 2007;38:99-101.
35. Touraud JP, Lentz N, Dutronc Y, et al. Umbilical cutaneous
metastasis (or Sister Mary Joseph’s nodule) disclosing an
ovarian adenocarcinoma. Gynecol Obstet Fertil 2000;28:
719-21.
36. Lee WJ, Chou CJ. Sister Mary Joseph’s nodule. Emerg Med
J 2006;23:956.
37. Victory R, Diamond MP, Johns DA. Villar’s nodule:a case
report and systematic literature review of endometriosis
externa of the umbilicus. J Minim Invasive Gynecol 2007;
14:23-32.
38. Kolwijck E, Kruitwagen RF, Massuger LF. Sister Mary Joseph
nodule as a first and only sign of extraovarian carcinoma:a
case report and review of the literature. Arch Pathol Lab
Med 2008;132:1943-5.
39. Alnaqbi KA, Joshi S, Ghazal-Aswad S, et al. Primary umbilical
adenocarcinoma. Singapore Med J 2007;48:e308-10.
40. Meine JG, Bailin PL. Primary melanoma of the umbilicus:
report of a case and review of the relevant anatomy.
Dermatol Surg 2003;29:405-7.
41. Handa U, Garg S, Mohan H. Fine-needle aspiration cytology
of Sister Mary Joseph’s (paraumbilical) nodules. Diagn
Cytopathol 2008;36:348-50.
42. Gupta RK, Naran S, McHutchison AG, et al. Diagnosis of
umbilical metastasis (Sister Mary Joseph’s nodule) by fineneedle
aspiration:an immunocytochemical study. Diagn
Cytopathol 1994;10:126-9.
43. Galvañ VG. Sister Mary Joseph’s nodule. Ann Intern Med
1998;128:410.
44. Larentzakis A, Theodorou D, Fili K, et al. Sister Mary Joseph’s
nodule:Three case reports. Cases J 2008;1:182.
45. Sugarbaker PH. Sister Mary Joseph’s sign. J Am Coll Surg
2001;193:339-40.
46. Masmoudi A, Boudaya S, Charfeddine A, et al. Sister Mary
Joseph’s nodule: report of five cases. Int J Dermatol 2008;
47:134-6.
47. Majmudar B, Wiskind AK, Croft BN, et al. The Sister (Mary)
Joseph nodule: it’s significance in gynaecology. Gynecol
Oncol 1991;40:152-9.
umbilicus: is it always of gastric origin? A review of eight
cases at different sites of origin. Indian J Cancer 2010;47:65-
9.
2. Lookingbill D, Spangler N, Sexton FM. Skin involvement as
the presenting sign of internal carcinoma. A retrospective
study of 7316 cancer patients. J Am Acad Dermatol 1990;22:
19-26.
3. Nakamura M, Tamura J, Takaki R, et al. Sister Mary Joseph’s
nodule. Intern Med 2009;48:1775.
4. Khan AJ, Cook B. Metastaic carcinoma of umbilicus: “Sister
Mary Joseph’s nodule”. Cutis 1997;60:297-8.
5. Dubreuil A, Dompmartin A, Barjot P, et al. Umbilical metastasis
or Sister Mary Joseph’s nodule. Int J Dermatol 1998;37:7-13.
6. Zadeh VB, Kadyan R, Al-Abdulrazzaq A, et al. Sister Mary
Joseph’s nodule: a case of umbilical cutaneous metastasis
with signet ring cell histology. Indian J Dermatol Venereol
Leprol 2009;75:503-5.
7. Shen Z, Yang X, Chen L, et al. Sister Mary Joseph’s nodule as
a diagnostic clue to metastatic colon carcinoma. J Clin
Oncol 2009;27:e1-2.
8. Gabriele R, Conte M, Egidi F, et al. Umbilical metastases:
current viewpoint. World J Surg Oncol 2005;3:13.
9. Yendluri V, Centeno B, Springett G. Pancreatic cancer
presenting as a Sister Mary Joseph’s nodule: case report
and update of the literature. Pancreas 2007;34:161-4.
10. Lin CC, Liu KL, Lin JT, et al. Education and imaging.
Gastrointestinal: Sister Mary Joseph nodule. J Gastroenterol
Hepatol 2008;23:1462.
11. Abu-Hilal M, Newman JS. Sister Mary Joseph and her
nodule: historical and clinical perspective. Am J Med Sci
2009;337:271-3.
12. Piura B. Umbilical metastasis:Sister Mary Joseph’s nodule.
Harefuah 2006;145:505-9.
13. Barrow MV. Metastatic tumors of the umbilicus. J Chronic
Dis. 1966;19:1113-7.
14. Steensma DP. Sister (Mary) Joseph’s nodule. Ann Intern
Med 2000;133:237.
15. Albano EA, Kanter J. Sister Mary Joseph’s nodule. N Engl J
Med 2005;352:1913.
16. Bailey H. Demonstration of physical signs in clinical surgery,
11th ed. Baltimore: Williams & Wilkins; 1949. p. 227.
17. Powell FC, Cooper AJ, Massa MC, et al. Sister Joseph’s
nodule: a clinical and histologic study. J Am Acad Derm
1984;10:610-5.
18. Lee CK, Chang YW, Jung SH, et al. A case of Sister Mary
Joseph’s nodule as a presenting sign of gastric cancer.
Korean J Gastroenterol 2008;51:132-6.
19. Whang TB, Wang L, Peng DH. Gastric carcinoma of the
umbilicus: case report of Sister Mary Joseph nodule. Cutis
2010;85:90-2.
20. Sina B, Deng A. Umbilical metastasis from prostate carcinoma
(Sister Mary Joseph’s nodule): a case report and review of
literature. J Cutan Pathol 2007;34:581-3.
21. Limmathurotsakul D, Rerknimitr P, Korkij W, et al. Metastatic
mucinous cystic adenocarcinoma of the pancreas
presenting as Sister Mary Joseph’s nodule. JOP 2007;8:344-
9.
22. Baratta A, Gorin RJ, Costa R. Sister Mary Joseph nodule:a
case report. Cutis 2007;80:469-72.
23. Clague JE. Sister Joseph’s nodule. Postgrad Med J 2002;
78:174.
24. Gabriele R, Borghese M, Conte M, et al. Sister Mary Joseph’s
nodule as a first sign of cancer of the cecum: report of a
case. Dis Colon Rectum 2004;47:115-7.
25. Wu YY, Xing CG, Jiang JX, et al. Carcinoma of the right side
colon accompanied by Sister Mary Joseph’s nodule and
inguinal nodal metastases: a case report and literature
review. Chin J Cancer 2010;29:239-41.
26. Hopton BP, Wyatt JI, Ambrose NS. A case of Sister Mary
Joseph nodule associated with primary gastric lymphoma.
Ann R Coll Surg Engl 2005;87:W6-7.
27. Renner R, Sticherling M. Sister Mary Joseph’s nodule as a
metastasis of gallbladder carcinoma. Int J Dermatol 2007;
46:505-7.
28. Hodkinson HJ, Kew MC. Sister Joseph’s nodule in
hepatocellular carcinoma. Eur J Gastroenterol Hepatol
2001;13:865-7.
29. Liu CY, Yong CC, Wu SC, et al. Sister Mary Joseph’s nodule
associated with hepatocellular carcinoma. Surgery 2010;
147:167-8.
30. Fukuda H, Saito R. A case of Sister Mary Joseph’s nodule
from prostatic cancer. J Dermatol 2006;33:46-51.
31. Deb P, Rai RS, Rai R, et al. Sister Mary Joseph nodule as the
presenting sign of disseminated prostate carcinoma. J
Cancer Res Ther 2009;5:127-9.
32. Piura B, Meirovitz M, Bayme M, et al. Sister Mary Joseph’s
nodule originating from endometrial carcinoma incidentally
detected during surgery for an umbilical hernia: a case
report. Arch Gynecol Obstet 2006;274:385-8.
33. Behtash N, Mehrdad N, Shamshirsaz A, et al. Umblical
metastasis in cervical cancer. Arch Gynecol Obstet 2008;
278:489-91.
34. Wijekoon NS, Samarasekera DN. Sister Mary Joseph’s nodule
as the sole presenting feature of disseminated squamous
cell cancer of the esophagus: a rare case. J Gastrointest
Cancer 2007;38:99-101.
35. Touraud JP, Lentz N, Dutronc Y, et al. Umbilical cutaneous
metastasis (or Sister Mary Joseph’s nodule) disclosing an
ovarian adenocarcinoma. Gynecol Obstet Fertil 2000;28:
719-21.
36. Lee WJ, Chou CJ. Sister Mary Joseph’s nodule. Emerg Med
J 2006;23:956.
37. Victory R, Diamond MP, Johns DA. Villar’s nodule:a case
report and systematic literature review of endometriosis
externa of the umbilicus. J Minim Invasive Gynecol 2007;
14:23-32.
38. Kolwijck E, Kruitwagen RF, Massuger LF. Sister Mary Joseph
nodule as a first and only sign of extraovarian carcinoma:a
case report and review of the literature. Arch Pathol Lab
Med 2008;132:1943-5.
39. Alnaqbi KA, Joshi S, Ghazal-Aswad S, et al. Primary umbilical
adenocarcinoma. Singapore Med J 2007;48:e308-10.
40. Meine JG, Bailin PL. Primary melanoma of the umbilicus:
report of a case and review of the relevant anatomy.
Dermatol Surg 2003;29:405-7.
41. Handa U, Garg S, Mohan H. Fine-needle aspiration cytology
of Sister Mary Joseph’s (paraumbilical) nodules. Diagn
Cytopathol 2008;36:348-50.
42. Gupta RK, Naran S, McHutchison AG, et al. Diagnosis of
umbilical metastasis (Sister Mary Joseph’s nodule) by fineneedle
aspiration:an immunocytochemical study. Diagn
Cytopathol 1994;10:126-9.
43. Galvañ VG. Sister Mary Joseph’s nodule. Ann Intern Med
1998;128:410.
44. Larentzakis A, Theodorou D, Fili K, et al. Sister Mary Joseph’s
nodule:Three case reports. Cases J 2008;1:182.
45. Sugarbaker PH. Sister Mary Joseph’s sign. J Am Coll Surg
2001;193:339-40.
46. Masmoudi A, Boudaya S, Charfeddine A, et al. Sister Mary
Joseph’s nodule: report of five cases. Int J Dermatol 2008;
47:134-6.
47. Majmudar B, Wiskind AK, Croft BN, et al. The Sister (Mary)
Joseph nodule: it’s significance in gynaecology. Gynecol
Oncol 1991;40:152-9.
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Published
2010-04-01
How to Cite
1.
Euanorasetr C. Sister Mary Joseph’s Nodule as a Presenting Sign of Recurrent Gastric Carcinoma: A Case Report and Literature Review. Thai J Surg [Internet]. 2010 Apr. 1 [cited 2024 Apr. 19];31(2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/225884
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