Presentation
Itchy swelling of the umbilicus. Weight loss and abdominal distension
Patient Data
Age: 80 years
Gender: Female
From the case:
Sister Mary Joseph nodule - metastatic pancreatic cancer
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Solid heterogeneous nodule in the umbilicus without substantial increase in blood flow to suggest an inflammatory process
On the basis of the US...
From the case:
Sister Mary Joseph nodule - metastatic pancreatic cancer
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On the basis of the US findings CT to assess for intraperitoneal disease
Solid mass in the umbilicus is associated with multiple liver metastases, marked ascites and a large mass in the distal body of the pancreas.
Case Discussion
Sister Mary Joseph nodules represent metastases in the peritoneal cavity that enter the umbilicus usually from ovarian malignancy but can be seen in gastro-intestinal tumors including pancreas. It is unusual to be the presenting complaint as it occurs late in the disease progression.
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