Sister Mary Jospeh's nodule as initial presentation of carcinoma caecum-case report and literature review

Umbilical metastases [Sister Mary Joseph's nodules (SMJN)] are relatively rare and are associated usually with advanced intra-abdominal tumors from the gastrointestinal tract (GIT) or from the gynecological malignancies and they carry poor prognosis. Here we report a case of carcinoma caecum whose initial presentation was with umbilical metastases and a review of literature in relation to the umbilical metastases from colonic tumors.

Umbilical metastases [Sister Mary Joseph's nodules (SMJN)] are relatively rare and are associated usually with advanced intra-abdominal tumors from the gastrointestinal tract (GIT) or from the gynecological malignancies and they carry poor prognosis. Here we report a case of carcinoma caecum whose initial presentation was with umbilical metastases and a review of literature in relation to the umbilical metastases from colonic tumors.

All umbilical nodules should be biopsied as their metastases are associated with poor prognosis. The ease of identification of the nodule underlines the importance of good clinical examination. Identification of these nodules needs high awareness, increased levels of clinical suspicion and would lead to appropriate prognostication of the patients. Combined modality treatment is the way forward in these groups of patients.