Abstract
Introduction: Umbilical metastasis from malignant tumors is called Sister Mary Josephʼs Nodule (SMJN), and is assumed as a sign of poor prognosis. Herein, we report one case of SMJN from breast cancer that we detected during an operation for intestinal obstruction.
Case: A 74 year-old woman. The patient had been diagnosed as having carcinoma of the breast on the right side and undergone right mastectomy and axillary lymph node dissection at the age of 65 years. She visited our hospital with the chief complaint of abdominal pain. Based on careful physical examination, she was diagnosed as having ileus due to obstruction of the small intense and was scheduled for surgery. During the surgery, evidence of malignant peritoneal dissemination with a large number of peritoneal nodules was found, and masses were also recognized in the umbilical region and small intestine. Therefore, resection of the umbilical mass and partial resection of the small intestine were performed. Histopathological examination showed umbilical metastasis and dissemination to the small intestine from breast cancer. After consulting with the patient and her family, we decided to observe the patientʼs progress under best supportive care (BSC); the patient died 168 days after the first medical examination.
Conclusion: SMJN is a rare disease, however, the possibility of SMJN should be considered in patients detected to have changes in the umbilical region during routine medical work.
