Sister Mary Joseph nodule: metastatic pancreatic cancer

Case contributed by Dr Chris O'Donnell

Presentation

Itchy swelling of the umbilicus. Weight loss and abdominal distension

Patient Data

Age: 80
Gender: Female

Solid heterogeneous nodule in the umbilicus without substantial increase in blood flow to suggest an inflammatory process

CT

On the basis of the ultrasound findings, CT was performed 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 tumours including pancreas.  It is unusual to be the presenting complaint as it occurs late in the disease progression.

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Case information

rID: 37661
Case created: 17th Jun 2015
Last edited: 1st Aug 2016
Inclusion in quiz mode: Included

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