Sister Mary Joseph’s nodule: an unusual but important physical finding characteristic of widespread internal malignancy

Abstract

Sister Mary Joseph’s nodule is an eponymous term referring to a malignant metastatic umbilical nodule. It is a rare but important physical finding as it is a sign of advanced stage of malignancy. This case report describes an 82-year-old female diagnosed with metastatic pancreatic adenocarcinoma presenting with a Sister Mary Joseph’s nodule. This is an unusual presentation of pancreatic malignancy. An 82-year-old woman presented to the GP with a 4-week history of an umbilical nodule (Figure 1). This was suspected to be a neoplastic lesion and she was referred to the dermatology department for further assessment. She was otherwise asymptomatic. She had a past medical history of type 2 diabetes mellitus, essential hypertension, and anaemia due to chronic kidney disease. On examination, she looked well with no abdominal discomfort. There was a 3 cm umbilical nodule and bilateral inguinal lymphadenopathy. The working diagnosis was a Sister Mary Joseph’s nodule with underlying internal malignancy. Figure 1 A Sister Mary Joseph’s nodule. Urgent outpatient investigations were arranged. Blood tests demonstrated …