Presentation
Known metastatic pancreatic cancer. Now has a palpable lump in umbilicus.
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
Subtle but definite thickening of the greater omentum (arrow) indicative of peritoneal metastases extending via an umbilical hernia into the umbilicus where there is a more focal (solid) mass indicative of a Sister Mary Joseph tumor nodule.
Case Discussion
These Mary Joseph nodules reflect peritoneal tumor infiltration (ovarian, gastro-intestinal including pancreas primary) to enter the umbilicus via transcoelomic spread . They can also arrive in the umbilicus via the para-umbilical vein. In this case a small umbilical hernia has allowed tumor in the greater omentum to exit the abdominal cavity.