The Sister (Mary) Joseph nodule: Its significance in gynecology

Majmudar, Bhagirath; Wiskind, Anne K.; Croft, Barbara N.; Dudley, Ainsworth G.

doi:10.1016/0090-8258(91)90108-h

Cited by 100 publications

(90 citation statements)

References 21 publications

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“…However, prognosis also depends on the primary lesion type and the organ affected. It has been noted that patients with ovarian cancer have a better survival rate than do patients with other malignancies 5,14,15 .…”

Section: Discussionmentioning

confidence: 99%

“…When a patient presents with an umbilical nodule, fine-needle aspiration biopsy is adequate to establish an easy and early diagnosis 9 . Studies have shown that most umbilical lesions are primaries 4 ; when they are metastatic (as in smj n), most are diagnosed as adenocarcinoma 5 . Among all reported cases of smj n, 35%-65% metastasize from gastrointestinal malignancies; 12%-35%, from the genitourinary tract; 15%-30%, from unknown sites; and 3%-6%, from other malignancies such as those of the lung and breast 10 .…”

Section: Casementioning

confidence: 99%

“…Mary Joseph nodule can be a presenting symptom or sign of undiagnosed underlying malignancy, or an alarming symptom or sign of disease progression or recurrence in a known patient 5 . Here, we report 4 cases of smjn encountered at our institute.…”

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confidence: 99%

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Umbilical Metastasis: A Case Series of Four Sister Joseph Nodules from Four Different Visceral Malignancies

et al. 2010

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Sister Joseph nodule is a metastatic umbilical lesion secondary to a primary malignancy of any viscera. It can be a presenting symptom (a sign of undiagnosed malignancy) or a symptom or sign of progression or recurrence in a known case. Its incidence is 1–3% of all intra-abdominal or pelvic malignancies. Here, we present 4 such cases, with Sister Joseph nodule as a finding of (1) presentation in a case of gallbladder carcinoma, (2) progression in a case of malignant gastrointestinal stromal tumour, (3) recurrence in a case of ovarian carcinoma, and (4) presentation in a case of rectal carcinoma. The clinicopathologic features of all 4 patients are discussed, and the related literature is briefly reviewed.

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Section: Discussionmentioning

confidence: 99%

Section: Casementioning

confidence: 99%

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Umbilical Metastasis: A Case Series of Four Sister Joseph Nodules from Four Different Visceral Malignancies

et al. 2010

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“…However, our third patient is the only cervical cancer case we have seen with metastatic umbilical nodule. The tumour types that may metastasize to the umbilicus are the adenocarcinomas, while squamous cell and undifferentiated carcinomas are rather uncommon (5,15). Ovarian and endometrial cancers are gland forming and this fact may explain their tendency to metastasize to the umbilicus.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous umbilical metastases in post-menopausal females with gynaecological malignancies

Samaila

Adesiyun

Waziri

et al. 2012

J Turkish German Gynecol Assoc

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Gynaecological malignancies frequently metastasize to contiguous structures, internal organs and bones. Cutaneous metastasis as a primary or recurrent presentation of these malignancies is rare and only a few cases have been reported in the literature. A twenty year (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) retrospective search for umbilical metastasis from gynaecological malignancies in our departmental case records showed only four cases. Four postmenopausal females presented with painful cutaneous umbilical (Sister Joseph's) nodules. The clinical examinations of all four patients revealed well delineated nodules of varying sizes and degrees of ulceration. Other findings were matted axillary and inguinal lymph node enlargement, intra-abdominal and pelvic masses, vaginal discharge and vaginal bleeding. Incisional tissue biopsies from the nodules were processed in paraffin wax and stained with haematoxylin and eosin. Histology of the sections showed pigmented skin overlying metastatic malignant tumours consistent with adenocarcinoma from the endometrium and ovary in three cases, and squamous cell carcinoma, large cell keratinizing from the cervix uteri in the fourth case. Gynaecological cancers have a global spread and varied geographic distribution. Cervical cancer is the commonest in our setting and patients often present to hospital with advanced stage disease. Ovarian and endometrial cancers are infrequent and their diagnosis may be delayed by non-specificity of presenting clinical symptoms from other benign tumours at these sites. Although umbilical metastasis is commonly associated with gastro-intestinal malignancies, its presence may be the first harbinger of occult gynaecologic cancer. (J Turkish-German Gynecol Assoc 2012; 13: 204-7)Key words: Metastasis, umbilical, cervix uteri, squamous cell carcinoma, endometrial adenocarcinoma Received: 04 November, 2011 Accepted: 03 January, 2012Jinekolojik maligniteler sıklıkla komşu yapılara, iç organlara ve kemiklere metastaz yaparlar. Bu malignitelerin primer veya rekürren prezentasyonu olarak deri metaztazları enderdir ve literatürde sadece bir kaç olgu bildirilmiştir. Jinekolojik malignitelerden kaynaklanan umbilikal metaztazlar için departmanımızın olgu kayıtlarında yirmi yıllık (1991-2010) retrospektif taramada sadece dört olgu bulundu. Menopoz sonrası dört kadın deriyi tutan ağrılı umbilikal nodüllerle (Rahibe Joseph) başvurmuştu. Dört hastanın klinik muayenesi farklı büyüklükte ve farklı ülserasyon derecelerinde iyi sınırlanmış nodülleri ortaya koymuştu. Diğer bulgular aksillar ve inguinal lenf nodlarında paket halinde büyüme, karın içi ve pelvik kitleler, vajinal akıntı ve vajinal kanama idi. Nodüllerden insizyonla elde edilen doku biyopsileri parafin mumunda işlenmiş ve hematoksilin-eozin ile boyanmıştı. Kesitlerin histolojisi üç olguda endometriyum ve overden köken alan adenokarsinoma ile uyumlu metastatik malign tümör ve üstünü örten pigmente deriyi, dördüncü olguda servik...

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“…In 14-33% of cases, umbilical metastases lead to the diagnosis of previously occult neoplasms. 7 In 40% of patients with a known neoplasm the nodule was an early sign of relapse. 8 Spread of metastatic carcinoma to the umbilical region has been hypothesized to occur by either 1) contiguous spread of peritoneal cancer, 2) hematogenous spread through arterial and venous systems, 3) lymphatic spread (mainly pancreatic carcinoma) or 4) extension along ligaments of embryonic origin (round ligament of liver, urachus, vitello intestinal duct remnant and the obliterated vitelline artery).…”

Section: Case Reportmentioning

confidence: 99%

A rare case of Sister Mary Joseph nodule as the only sign of unknown primary malignancy

et al. 2016

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The Sister (Mary) Joseph nodule: Its significance in gynecology

Cited by 100 publications

References 21 publications

Umbilical Metastasis: A Case Series of Four Sister Joseph Nodules from Four Different Visceral Malignancies

Umbilical Metastasis: A Case Series of Four Sister Joseph Nodules from Four Different Visceral Malignancies

Cutaneous umbilical metastases in post-menopausal females with gynaecological malignancies

A rare case of Sister Mary Joseph nodule as the only sign of unknown primary malignancy

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