Photo Quiz
Hint: Patient presents with progressive abdominal distension
Answer: Sister Mary Joseph Nodule
The finding of a hard subcutaneous nodule at the umbilicus secondary to metastatic carcinoma is referred to as Sister Mary Joseph's Nodule. This is a sign of metastatic intra-abdominal malignancy and signals advanced disease with a poor prognosis. The most common malignancies associated with a Sister Mary Joseph Nodule are adenocarcinoma of the stomach, colon, pancreas and ovary.
In critical Care, Umblicus should be examined in patients with Ascites. This is an easy and quick clinical sign.
Reference:
Powell FC, Cooper AJ, Massa MC, Goellner JR, Daniel WP: Sister Joseph's nodule: a clinical and histologic study. J Am Acad Derm 1984, 10:610-615
Dubreuil A, Dompmartin A, Barjot P, Louvet S, Leroy D: Umbilical metastasis or Sister Mary Joseph's nodule.Int J Dermatol 1998, 37:70-73.
