Abstract
Background : Umbilical nodule, also known as Sister Mary Joseph’s nodule (SMJN), is mostly a metastatic manifestation of an underlying advanced malignant disease.
Case : A 52-year-old woman with lower abdominal pain was diagnosed as having a right ovarian tumor. The patient underwent hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy and tumor resection, followed by adjuvant chemotherapy with carbopratin and paclitaxel. The final diagnosis was ovarian endometrioid adenocarcinoma, stage IIIc. Twelve months after the surgery, the patient noticed a dark reddish-colored skin nodule measuring 3.0 cm in diameter around the umbilicus. Fine needle aspiration cytology (FNAC) showed scattered clusters of cells in a necrotic background. Most of the clusters were three-dimensional. Occasional papillary clusters were also seen. The tumor cells had large and hyperchromatic nuclei with prominent nucleoli. Based on these findings, the patient was diagnosed as having a recurrent tumor in the umbilicus. Subsequently, resection of the umbilical tumor was performed. The final diagnosis was umbilical metastasis from recurrent ovarian cancer.
Conclusions : Although patients with SMJN have a dismal prognosis, treatments such as surgical resection or chemotherapy may improve the prognosis. FNAC could be a simple, inexpensive and reliable technique for the diagnosis of SMJN. In the current case, the patient underwent surgical resection of the SMJN after the diagnosis had been made by FNAC.
