Sister Mary Joseph’s nodule in endometrial carcinoma: A case report

Yang, Li; Guo, Peng; Wang, Bin; Jia, Yitao

doi:10.12998/wjcc.v7.i20.3358

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…To authors knowledge around 32 cases have reported of SMJN of endometrial origin so far (Table 1). [8][9][10][11][12][13] Management is tailored to clinical condition of the patient and extent of resection of the local umbilical site tumour. In all cases reported so far, primary surgery with adjuvant chemotherapy has survival benefits over surgery or chemotherapy alone.…”

Section: Discussionmentioning

confidence: 99%

Sister Mary Joseph’s nodule from primary endometrial carcinoma: a case report

Ramanathan

Nagandla

Jamli

2022

Int J Reprod Contracept Obstet Gynecol

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Sister Mary Joseph’s nodule (SMJN) refers to umbilical metastases is rare and is likely be the first manifestation of an underlying malignancy likely gastrointestinal or genital in origin. The incidence reported is about 1-3% and has a poor prognosis with an overall survival (OS) of 2-11 months from the initial diagnosis. The ovarian location is incriminated the most common site followed by endometrium in gynaecological cancers. Only 32 cases of SMJN from endometrium with have been reported in the published literature. A 57-year-old postmenopausal woman, presented with a large bleeding and infected umbilical mass and symptomatic anaemia. A diagnosis of SMJN was made following biopsy of the mass which revealed metastasis of an endometrial adenocarcinoma. She underwent 6 cycles of neoadjuvant chemotherapy. Subsequent laparotomy including full resection of the umbilical lesion, abdominal wall reconstruction with composite mesh, and a total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy and bilateral lymph nodes excision. Histological diagnosis revealed metastasis from primary endometrial carcinoma. Currently patient condition is stable and is on follow up. This is the 33rd case as reported in the literature of SMJN originating from endometrial carcinoma from authors knowledge. Our approach was multimodal with neoadjuvant chemotherapy followed by surgery and adjuvant radiotherapy. Currently there is no specific recommendation and management should be individualised.

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Section: Discussionmentioning

confidence: 99%

Sister Mary Joseph’s nodule from primary endometrial carcinoma: a case report

Ramanathan

Nagandla

Jamli

2022

Int J Reprod Contracept Obstet Gynecol

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“…Umbilical metastasis, also known as SMJN named by Dr. Hamilton Bailey [22] .The most common pathological type of SMJN is adenocarcinoma [23] . The most common primary tumor sites are stomach for male, colon and female ovaries; other tumors sites such as pancreas, liver, biliary tract, fallopian tube and uterus also had been reported [24] , [25] , [26] . The routes of metastasis could be peritoneum, blood-borne artery, vein system, lymphatic vessel, and along the ligament of embryonic origin (round ligament, falciform ligament) or laparoscopic direct implantation [27] .…”

Section: Discussionmentioning

confidence: 99%

Metastasis of missed cholangiocarcinoma in the left lobe through abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: Case report and literature review

Huang¹,

Li²,

Chen³

et al. 2021

Radiology Case Reports

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Laparoscopic cholecystectomy (LC) has been widely used by surgeons. However, the missed diagnosis of intraperitoneal malignant tumor may occur. If the malignancy exists, the changes of the abdominal environment or the laparoscopic operation might brought the cancer cells to abdominal cavity or wall, to more extreme condition, will be located in the navel, which is known as Sister Mary Joseph's nodule(SMJN). A 63-year-old female who had undergone cholecystectomy and choledocholithotomy ten months ago was hospitalized for upper abdominal pain. Laboratory examination indicated that most of tumor markers were increased. CT revealed a progressively enhanced mass around the left lobe bile duct, multiple enlarged lymph nodes in the abdominal cavity and nodular lesions were found under the costal margin of the right side of abdominal wall and the umbilicus. Biopsy of the nodules under the original surgical scar showed middle differentiated adenocarcinoma. In laparoscopic cholecystectomy, surgeons should not only focus on the local lesions, but also look around other the tissues and organs to avoid missing the abdominal malignant tumor. When atypical symptoms or abnormalities have been found pre-operation, all abdominal organs should be evaluated in detail to avoid missed diagnosis of potential malignant tumors. On the other hand, when there is a nodule in the umbilicus, all organs in abdomen should be examined to find the potential malignant tumor. Finally, multiple cholelithiasis in the left lobe of the liver should be regarded as a high risk factor for cholangiocarcinoma.

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“…Umbilical metastasis, also known as SMJN named by Dr. Hamilton Bailey [22].The most common pathological type of SMJN is adenocarcinoma [23]. The most common primary tumor sites are stomach for male, colon and female ovaries; other tumors sites such as pancreas, liver, biliary tract, fallopian tube and uterus also had been reported [24][25][26]. The routes of metastasis could be peritoneum, blood-borne artery, vein system, lymphatic vessel, and along the ligament of embryonic origin (round ligament, falciform ligament) or laparoscopic direct implantation [27].…”

Section: Discussionmentioning

confidence: 99%

Metastasis of missed cholangiocarcinoma in the left lobethrough abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: case report and literature review

Huang

Jiang

et al. 2020

Preprint

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Introduction: Laparoscopic cholecystectomy (LC) has been widely used by surgeons. However, a serious but rare condition may be happened, which is the missed diagnosis of intraperitoneal malignant tumor. If the malignancy exists, the changes of the abdominal environment or the laparoscopic operation might brought the cancer cells to the abdominal cavity or the abdominal wall. The missed laparoscopic malignant tumors are prone to metastasis, especially at the laparoscopic port-site. More extreme condition will be located in the navel, which is known as Sister Mary Joseph’s nodule(SMJN).Case presentation: A 63-year-old female who had undergone cholecystectomy and choledocholithotomy ten months ago was hospitalized for upper abdominal pain. Laboratory examination indicated that the most of tumor markers were increased. CT scan revealed that there was a diffused irregular and progressively enhanced mass around the left lobe bile duct, multiple enlarged lymph nodes in the abdominal cavity and multiple nodular lesions were found under the costal margin of the right upper abdominal wall, right lower abdominal wall and the umbilicus. Biopsy of the nodules under the original surgical scar showed an infiltrative or metastatic middle differentiated adenocarcinoma. So the diagnosis was left lobe cholangiocarcinoma of the liver, multiple lymph nodes metastasis in the abdominal cavity and multiple implant metastasis in abdominal wall laparoscopic port-site and umbilical.Conclusion: In laparoscopic cholecystectomy, surgeons should not only focus on the local lesions, like gallstone in biliary system, but also look around other the tissues and organs to avoid missing the abdominal malignant tumor or other lesions. When atypical symptoms or abnormalities have been found pre-operation, all abdominal organs should be evaluated in detail to avoid missed diagnosis of potential malignant tumors. On the other hand, when there is a nodule in the umbilicus, all the organs and tissues in abdomen should be examined to find the potential malignant tumor. Finally, multiple cholelithiasis in the left lobe of the liver should be regarded as a high risk factor for cholangiocarcinoma.

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Sister Mary Joseph’s nodule in endometrial carcinoma: A case report

Cited by 6 publications

References 12 publications

Sister Mary Joseph’s nodule from primary endometrial carcinoma: a case report

Sister Mary Joseph’s nodule from primary endometrial carcinoma: a case report

Metastasis of missed cholangiocarcinoma in the left lobe through abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: Case report and literature review

Metastasis of missed cholangiocarcinoma in the left lobethrough abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: case report and literature review

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