Two Cases of Umbilical Metastasis (Sister Mary Joseph’s Nodule) from Abdominal Malignant Tumors

Abstract

We treated two cases of Sister Mary Joseph’s nodule (umbilical metastatic carcinoma, SMJN). Case 1 was a 33-year-old female who had been admitted to our hospital complaining of an umbilical mass. Contrast CT imaging enabled a diagnosis of umbilical metastasis together with multiple metastases in the liver and para-aortic lymph nodes. Because surgery was not indicated, we used chemotherapy. The patient’s disease stabilized during the first chemotherapy regimen. During the treatment, however, pain caused by the umbilical metastasis prompted the surgical removal of the ascending colon, umbilicus, and ovaries. The patient continued to receive chemotherapy, but she died from cancer one year and seven months after onset. Case 2 is an 83-year-old female who complained of an umbilical mass. Contrast CT imaging showed a locally progressive pancreatic tail cancer with severe liver metastases. Although chemotherapy was applied, she died five months after onset. SMJN has a poor prognosis; hence, when SMJN is found during an examination, the primary disease should always be considered.