DOI: 10.12890/2025_006004

The umbilical clue: recognizing Sister Mary Joseph’s nodule

Authors

  • João Lança Pereira Serviço de Medicina Interna, ULS Viseu Dão-Lafões, Viseu, Portugal
  • Elisa Veigas Serviço de Medicina Interna, ULS Viseu Dão-Lafões, Viseu, Portugal
  • Catarina Rodrigues da Silva Serviço de Medicina Interna, ULS Viseu Dão-Lafões, Viseu, Portugal
  • Nídia Oliveira Serviço de Medicina Interna, ULS Viseu Dão-Lafões, Viseu, Portugal
  • Vitor Oliveira Serviço de Medicina Interna, ULS Viseu Dão-Lafões, Viseu, Portugal
  • Eurico Oliveira Serviço de Medicina Interna, ULS Viseu Dão-Lafões, Viseu, Portugal

joao.lanca0000@gmail.com

Keywords

Sister Mary Joseph’s nodule, endometrial adenocarcinoma, umbilicus, abdominal malignancy, umbilical skin metastasis

Abstract

Background: Sister Mary Joseph’s nodule (SMJN) is a rare manifestation of intra-abdominal malignancy presenting as a metastatic umbilical lesion.
Case report: An 82-year-old woman with no prior medical history presented with a violaceous, ulcerated umbilical lesion. Imaging revealed peritoneal carcinomatosis, pelvic lymphadenopathy, and suspicious endometrial mass. Biopsies of both the cutaneous and endometrial lesions identified a serous endometrial adenocarcinoma with umbilical metastasis, confirmed by immunohistochemical markers (CK7+, PAX8+, CK20-, CDX2-). Given the extent of lymphatic and peritoneal spread, the patient was referred to palliative care.
Conclusion: SMJN accounts for approximately 10% of cutaneous metastases and often signifies advanced disease with a poor prognosis. Although rare, it may be the first visible sign of a hidden malignancy. This case highlights the importance of considering SMJN in differential diagnoses of umbilical lesions and underscores the need for prompt investigation to determine the underlying pathology. Early recognition can aid in appropriate management, although treatment is typically palliative due to the advanced stage at diagnosis.

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References

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Published

2025-12-04

Issue

Vol. 13 No. 1 (2026)

Categories

How to Cite

1.
Lança Pereira J, Veigas E, Rodrigues da Silva C, Oliveira N, Oliveira V, Oliveira E. The umbilical clue: recognizing Sister Mary Joseph’s nodule. EJCRIM [Internet]. 2025 Dec. 4 [cited 2026 Nov. 4];13(1). Available from: https://ejcrim.com/index.php/ejcrim/article/view/6004