Sister Mary Joseph nodule: it does not bode well

Autopsy and Case Reports. ISSN 2236-1960. Copyright © 2014. This is an Open Access article distributed of terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted noncommercial use, distribution, and reproduction in any medium provided article is properly cited. Sister Mary Joseph, the superintendent nurse and surgical assistant of Dr. William Mayo at St Mary’s Hospital (presently Mayo Clinic), was the first to note the association of umbilical nodules with intraabdominal malignancy.1,2 Dr. Hamilton Bailey, a British surgeon, in his classic book Physical Signs in Clinical Surgery3 named the lesion for Sister Mary Joseph; the palpable bulging usually firm nodule distorting and invading into the umbilicus as a manifestation of metastatic malignancy from the abdomen or the pelvis. Sister Mary Joseph’s nodule (SMJN), was at the time of its description, recognized as metastatic disease.3