An 81-year-old man presented with a nonbleeding umbilical nodule that developed 2 weeks before presentation (panel A). This is a palpable nodule that is often protruding from the umbilicus which represents malignant and metastatic cancer. J Am Osteopath Assoc 2012;112(7):462. doi: https://doi.org/10.7556/jaoa.2012.112.7.462. 1 Cases of Sister Mary Joseph nodules are seen infrequently in patients with prostate cancers and foretell poor outcomes. The patient underwent 3 infusions of sipuleucel-T immunotherapy, at which time the umbilical nodule developed. These malignancies are usually associated with the ovary and gastrointestinal tract. In medicine, the Sister Mary Joseph nodule or more commonly node, also called Sister Mary Joseph sign, refers to a palpable nodule bulging into the umbilicus as a result of metastasis of a malignant cancer in the pelvis or abdomen. Sister Mary Joseph nodule (also called Sister Mary Joseph node or sign) What does is represent? It is important to know about this clinical condition, its aetiology and … Sister Mary Joseph Nodule Sister Mary Joseph nodule is metastatic carcinoma of the umbilicus, usually adenocarcinoma from the stomach, large bowel, ovary, or pancreas. Sister Mary Joseph's (SMJ) nodule is a common term given to the metastatic umbilical nodules. Other conditions that can cause a palpable periumbilical … From: Evidence-Based Physical Diagnosis (Fourth Edition), 2018 What is Sister Mary Joseph nodule of the umbilicus?. © 2020 by the American Osteopathic Association, This PDF is available to Subscribers Only, Sister Mary Joseph Nodule From Prostate Cancer, From the departments of internal medicine (Dr Kruczek) and hematology and oncology (Dr Nabhan) at Advocate Lutheran General Hospital in Park Ridge, Illinois. You can manage this and all other alerts in. The patient died approximately 10 months later. He completed 4.5 cycles of lenalidomide (28-day cycle; 25 mg on days 1-21) but discontinued therapy because of fatigue. Biopsy of the nodule revealed the presence of PSA, confirming metastasis from prostate cancer (panel B). Sister Mary Joseph nodule as the presenting sign of disseminated prostate carcinoma. Sister Mary Joseph nodules are rare physical findings usually seen in patients with gastric or ovarian malignancies. By continuing to use our website, you are agreeing to, The Journal of the American Osteopathic Association, https://doi.org/10.7556/jaoa.2012.112.7.462. The authors report the case of a Sister Mary Joseph nodule originating from the bifurcation of the common hepatic duct. Sina B, Deng A. Umbilical metastasis from prostate carcinoma (Sister Mary Joseph's nodule): a case report and review of the literature. The patient had a history of prostate cancer that was diagnosed in 1995 (Gleason score, 8; prostate-specific antigen [PSA] level, 29 ng/mL) and managed with external beam radiotherapy and brachytherapy. SMJN is a metastatic tumor nodule of the umbilicus usually as a result of contiguous extension from the anterior peritoneal surface. The patient developed metastatic cancer with bladder invasion in 2010. 2 … It was named after Sister Mary Joseph who assisted Dr. Mayo during the 1890s and noted umbilical lesions among patients with intra-abdominal malignancies . Sister Mary Joseph nodules represent metastatic cancer of the umbilicus. Malignant umbilical nodules may be the presenting feature in a variety of malignancies. Topical antimicrobial treatment provided no resolution. A periumbilical mass is not always a Sister Mary Joseph nodule. Deb P, Rai RS, Rai R, Gupta E, Chander Y. This eponymous term refers to secondary cancer (metastasis) appearing in the umbilicus, usually spreading from advanced peritoneal adenocarcinoma. Antiandrogen therapy was initiated 6 years later because of elevated PSA levels (12.2 ng/mL). Address correspondence to Kimberly Kruczek, DO, Department of Internal Medicine, Advocate Lutheran General Hospital, 1775 Dempster St, Park Ridge, IL 60068-1143. Kruczek K, Nabhan C. Sister Mary Joseph Nodule From Prostate Cancer. E-mail: You will receive an email whenever this article is corrected, updated, or cited in the literature. Umbilical nodules should prompt clinical evaluations, as these tumors are usually associated with poor prognosis. Sister Mary Joseph nodules are rare physical findings usually seen in patients with gastric or ovarian malignancies. What cancers are most likely to cause this? About half of the cases of umbilical metastasis originate from intra-abdominal or pelvic structures, the majority being from the gastrointestinal tract (GIT). The name first was used in Hamilton Bailey's textbook of surgery in 1949. Who was Sister Mary Joseph? The patient died approximately 10 months later. Sister Mary Joseph nodules can be painful to palpation. This site uses cookies.