Pancreatic cancer presenting as a Sister Mary Joseph's nodule

Prabhu, Raghunath; Krishna, Sunil; Shenoy, Rajgopal; Natarajan, Arjun

doi:10.1136/bcr-2013-201020

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…Cutaneous metastasis from pancreatic carcinoma is sufficiently uncommon that it is not listed separately among the various primary sites or is represented by 2 or 3 cases in series, which are dominated by breast, lung, and colorectum . The umbilical centered metastasis or the eponymic Sister Mary Joseph nodule is the most common cutaneous site of metastatic pancreatic carcinoma where it may be the initial sign of disease . However, our patient is unusual in several respects with a non‐umbilical metastasis to the scalp as an example of distant metastasis of a pancreatic carcinoma; this atypical presentation of bone and skin metastases is reasonably explained by the well‐documented aggressive ASCA with its abbreviated median survival compared to the other pathologic types of pancreatic ductal carcinoma.…”

Section: Discussionmentioning

confidence: 71%

Metastatic pancreatic adenosquamous carcinoma to the scalp: A case report and review of the literature

et al. 2019

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Metastatic carcinoma to the skin occurs in only a minority of patients with a visceral or internal malignancy, with breast, lung, and colorectum accounting for the majority of cases. We present the case of a 66-year-old man with a recent violaceous nodule of the left scalp (1.2 × 1.0 × 0.2 cm) that was a metastatic pancreatic adenosquamous carcinoma, representing a seemingly rare event. Two months prior, after complaining of right hip pain, an image revealed a right femoral lesion. A biopsy of that lesion showed moderately differentiated adenocarcinoma. Subsequent imaging showed a mass in the pancreatic tail and also markedly elevated serum tumor markers, CA 19-9 and carcinoembryonic antigen (5325 and 111.5 U/mL, respectively). Before the appearance of the scalp nodule, the patient received radiotherapy and was started on chemotherapy, which was continued after diagnosis and resection of the nodule. Subsequent metastases developed in the liver, lung and additional cutaneous lesions. He died 11 months after initial presentation with right hip pain. As this case shows, cutaneous metastases confer a poor prognosis, often with less than a year survival following their appearance.

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Section: Discussionmentioning

confidence: 71%

Metastatic pancreatic adenosquamous carcinoma to the scalp: A case report and review of the literature

et al. 2019

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“…In pancreatic ductal adenocarcinoma, more than 90% of cases show expression of CK7 and 50% show positivity for CK 19. 11 , 12 The expression of CK 20 was variable, which had an impact on the clinical outcome. In addition, the elevation of CA19-9 is a strong evidence of pancreatic cancer.…”

Section: Discussionmentioning

confidence: 99%

Sister Mary Joseph Nodule as an Initial Presentation of Pancreatic Adenocarcinoma

et al. 2020

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Sister Mary Joseph (SMJ) nodule is a metastatic umbilical nodule seen in primary tumors of the gastrointestinal or genitourinary tract. The stomach and colon are the common gastrointestinal cancers associated with SMJ nodule. The pancreas is a rare primary site for umbilical metastasis. Moreover, malignant umbilical nodules as the first presentation in pancreatic cancer is rare. Pancreatic adenocarcinoma that metastasizes to umbilicus usually arise from the body or tail of the pancreas. The presence of SMJ nodule usually indicates poor prognosis. Umbilical nodule is a simple physical finding to the presence of an advanced intra-abdominal malignancy. Although rare, pancreatic cancer should be considered as one of the primary sites in such a situation.

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“…Metastasis of internal tumors to umbilical skin, known as Sister Mary Joseph nodule (SMJN), is uncommon [ 1 , 2 ]. The metastasis to the umbilical skin is more common than other parts of the skin [ 3 , 4 ]. Sir Hamilton Bailey described SMJN in 1949 and there have been reports of more than 600 cases in the literature mainly from the stomach, ovary and large intestine since then [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Metastatic Pancreatic Adenocarcinoma to Umbilical Skin

Aghighi¹,

Shokravi²,

Rahvar³

2022

Cureus

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Sister Mary Joseph nodule (SMJN) is a rare metastasis to umbilical skin originating from internal tumors including the stomach, ovary and large intestine and less commonly from pancreatic cancers. We report an uncommon case of metastatic pancreatic adenocarcinoma to umbilical skin. An 85-year-old female presented with a 1.8 cm protrusion of the right lateral umbilicus. The CT scan showed a 3.5 cm pancreatic lesion, peritoneal carcinomatosis and abdominal lymphadenopathy. Histology examination revealed atypical infiltrative glandular structures. Immunohistochemistry showed positive CK7, negative CDX2 and P53 with mutated patterns. These were consistent with metastatic adenocarcinoma most consistent with pancreatobiliary or upper GI origin. CK7 expresses in the ductal cells in pancreatic ductal adenocarcinoma. While CDX2 is positive in intestinal-type adenocarcinoma, it is negative in pancreatic ductal adenocarcinoma. The diagnosis of adenocarcinoma is rendered based on the presence of a pancreatic lesion in CT scan, positive CK7 and negative CDX2 in umbilical nodule tumor cells in the current patient.

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Pancreatic cancer presenting as a Sister Mary Joseph's nodule

Cited by 6 publications

References 8 publications

Metastatic pancreatic adenosquamous carcinoma to the scalp: A case report and review of the literature

Metastatic pancreatic adenosquamous carcinoma to the scalp: A case report and review of the literature

Sister Mary Joseph Nodule as an Initial Presentation of Pancreatic Adenocarcinoma

Metastatic Pancreatic Adenocarcinoma to Umbilical Skin

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