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Sister Mary Joseph's Nodule -A Case Report and Review of the Literature-
Tsu-Man Chiu, Kao-Chia Yang, Chan-Hao Wang, Julia Huei-Mei Chan
Dermatol Sinica 17: 208-214, 1999

A 29-year-old man presented with a rapidly enlarging, 1.6×1.5 cm, firm, reddish, asymptomatic nodule on the umbilicus for 2 weeks. A skin biopsy specimen of the lesion showed mucin-producing adenocarcinoma, and the patient was diagnosed to have metastatic carcinoma of umbilicus: Sister Mary Joseph's nodule. Search for the primary tumor revealed adenocarcinoma of the stomach with peritoneal carcinomatosis. Sister Mary Joseph's nodule is a well-known entity. It is a rare form of cutaneous metastasis, which can present as the first sign of intra-abdominal malignancy, carrying very poor prognosis, and generally is inoperable. This report emphasizes that dermatologists must be aware of the diagnostic significance of this entity and the importance of histopathological assessment of recently acquired umbilical lesions.

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