Endometrial cancer diagnosed by Sister Mary Joseph nodule biopsy: Case report

Abstract

A Sister Mary Joseph nodule is an umbilical metastasis found in less than 3% of patients with intra-abdominal or pelvic malignancy (Piura et al., 2006). These rare nodules have a wide range of presentations but most typically are noted to be a painful, ulcerated mass with serosanguineous to bloody discharge (Levine et al., 2010). Although rarely reported, the presence of a Sister Mary Joseph nodule can be an important diagnostic and prognostic factor in the assessment of gynecologic oncology patients. In this case we describe a patient who presented with a likely gynecologic malignancy and notable Sister Mary Joseph nodule. As an endometrial or cervical biopsy was difficult due to heavy vaginal bleeding, biopsy of the umbilical nodule allowed for an early tissue diagnosis of papillary serous adenocarcinoma and subsequently helped to guide staging and treatment options.