Sister Mary Joseph's nodule.
BACKGROUND
Sister Mary Joseph's nodule (SMJN) represents an unusual clinical feature of metastatic deposit at the umbilicus originating from an intra-abdominal malignancy.


OBJECTIVE
To outline the paucity of such a condition, review the associated pathologies, and demonstrate the importance of clinical and histopathologic correlation.


METHODS
Case report of a 75-year-old man with vesical and prostatic cancers treated 2 years prior to presenting with an umbilical lesion. Histopathologic and radiologic examinations were performed to confirm the clinical diagnosis.


RESULTS
Histopathology of the umbilical biopsy revealed a carcinoma of urothelial origin, but immunohistochemistry suggested a squamous cell carcinoma. Clinically, the lesion did not support a diagnosis of primary squamous cell carcinoma; in addition, the positron emission tomographic scan revealed a captation at the ureterovesical junction that was compatible with vesical cancer relapse.


CONCLUSIONS
SMJN is a rare but typical cutaneous metastasis of internal malignancy, and its recognition is of great importance because it may be the first presenting sign in a patient with an unknown malignant disease.
Divion of Dermatolgy, CHUM-Hôpital Saint-Luc, Montreal, Quebec.
Sandra
S
Davar
Dominique
D
Hanna
D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D049268:Positron-Emission Tomography; D058288:Sister Mary Joseph's Nodule / Q000175:diagnosis* / Q000556:secondary*; D001749:Urinary Bladder Neoplasms / Q000473:pathology*
D014408:Biomarkers, Tumor