Sister Mary Joseph's Nodule as a First Manifestation of Primary Peritoneal Cancer

C Iavazzo,K Madhuri,N Akrivos,S Butler-Manuel,A Tailor,S Essapen

doi:10.1155/2012/467240

C Iavazzo, K Madhuri + Show 4 more

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https://doi.org/10.1155/2012/467240

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Abstract

Sister Mary Joseph's nodule metastasis is a rather rare finding. The primary malignancy in women is usually ovarian, endometrial, gastric, or pancreatobiliary tree cancer. We present a case of an 87-year-old patient with Sister Mary Joseph's nodule metastasis caused by a primary peritoneal malignancy. Through a literature search, we also discuss the pathophysiology, diagnostic approach, management, and prognosis of such a condition.

Highlights

Sister Mary Joseph’s nodule could be the first sign of internal malignancy which is usually found in the gastrointestinal tract (52%), female genital tract or genitourinary tract (28%), and nonspecified origin (18–20%) [1]
Mary’s Hospital in Rochester, Minnesota, when she identified that an umbilical nodule could be a sign of intra-abdominal or pelvic malignancy
The aim of this study is to present a case of a patient with Sister Mary Joseph’s nodule and discuss the process from diagnosis to management, as well as the possible mechanisms of such a metastasis, differential diagnosis, and prognosis

Summary

Introduction

Sister Mary Joseph’s nodule could be the first sign of internal malignancy which is usually found in the gastrointestinal tract (52%), female genital tract or genitourinary tract (28%), and nonspecified origin (18–20%) [1]. The majority of them are of gastric or ovarian origin; cases from appendix, gallbladder, pancreatic, hepatobiliary, or endometrial carcinomas are described in the literature [2,3,4]. When such a nodule is identified, it suggests the presence of a malignancy, and poor prognosis. Sister Mary Joseph whose name was Julia Dempsey (1856–1939) was working as a superintendent nurse at St. Mary’s Hospital in Rochester, Minnesota, when she identified that an umbilical nodule could be a sign of intra-abdominal or pelvic malignancy. The eponym was coined to her by Hamilton Bailey in 1949 in his book entitled “Demonstration of Physical Signs in Clinical Surgery” [5]

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