Sister Mary Joseph's nodule.

1 of 2 DESCRIPTION A 44-year-old female presented with 1-year history of progressive abdominal distension ( fi gure 1A ) which she thought might be related to pregnancy and a tumour protruding through her umbilical area that was oozing serosanguinous fl uid. The patient did not seek medical attention initially due to lack of insurance. CT of the abdomen ( fi gure 1B,C ) revealed a large mass with loculated ascites. Multiple lung nodules were identifi ed as well. The patient underwent tumour debulking that revealed a poorly differentiated malignant neoplasm ( fi gure 1D ) involving ovaries, the umbilical area and widespread omental metastases. Postoperatively the patient continued to produce massive amounts of ascites and ultimately succumbed due to sepsis. Sister Mary Joseph’s nodule, or a metastatic lesion of the umbilicus, was coined in 1949 by the english surgeon Sir Hamilton Bailey 1 after Sister Mary Joseph (1856– 1939), a surgical assistant for Dr William Mayo 2 , who was the fi rst to associate intra-abdominal malignancy and Images in...