Abstract
A 64-year-old male had received postoperative chemotherapy with S-1 for 12 months following macroscopically curative gastrectomy (R1) for stage IV gastric cancer with positive peritoneal seeding. Nineteen months after the resection, She felt something wrong with her umbilicus and an abdominal CT scan revealed the emergence of liver metastases and an umbilical nodule. Although the umbilical tumor seemed to disappear once after the sequential chemotherapy composed of S-1 for 3 months, biweekly irinotecan plus cisplatin for 8 months, and weekly paclitaxel for 7 months, the nodule started to increase in size again and caused umbilical pain afterwards, which required the resection of the umbilical tumor 23 months after the emergence of it. Pathological studies revealed moderately differentiated adenocarcinoma located in the subcutaneous region of the umbilicus, which was diagnostic of Sister Mary Joseph's nodule. To date, the patient has been alive for 44 months since the emergence of the Sister Mary Joseph's nodule, bearing liver metastases.
