Sister Mary Joseph's nodule.

A 95-year-old woman presented with an umbilical mass, pain, and loss of appetite over a three-week period. Physical examination showed a hard nodule protruding through the umbilicus (Picture 1). Computed tomography revealed a nodule at the umbilicus (Picture 2) along with multiple liver metastases. These results led to a diagnosis of a Sister Mary Joseph’s nodule (1). As a result of her advanced age, the patient did not undergo any further examinations or an active therapy. A Sister Mary Joseph’s nodule is known as a metastatic lesion of the umbilicus associated with cancers of the gastrointestinal tract and ovary. It is very rare as a first presenting sign of metastatic cancers. It is named after Sister Mary Joseph (1853-1939), a surgical assistant to Dr. William Mayo at St. Mary’s Hospital in Rochester, MN, USA, who identified the relationship between umbilical nodules and advanced intra-abdominal malignancy (1, 2).