Sister Mary Joseph Nodule as a Manifestation of Ovarian Tumor A case report

Introduction: Sister Mary Joseph's nodule is an umbilical skin lesion of metastatic origin secondary to neoplasm of any organ, mainly of intra-abdominal or pelvic location. It has an incidence of 1-3% in people diagnosed with abdominopelvic neoplasms. Case presentation: 63-year-old female patient with clinical symptoms of 4 months of evolution, consisting of increased volume at the level of the umbilicus with reddish colouration, hyporexia, weight loss, increased abdominal circumference, dyspepsia, emesis and oedema in the lower limbs. Abdominal examination revealed a nodular lesion in the umbilical region with a reddish-violet colour, a necrotic and friable centre, as well as a palpable stony hypogastrium with an irregular surface and a positive tarral sign. An abdominopelvic tomography was performed, which showed an increase in the size of the right adnexa, and cytology was taken by fine needle aspiration of the umbilical lesion, the analysis of which revealed a poorly undifferentiated carcinoma, and the existence of Sister Mary Joseph's nodule secondary to ovarian carcinoma was defined. Discussion: Sister Mary Joseph's nodule is an umbilical metastasis of unknown malignant neoplasm or a sign of recurrence in patients with a malignant anarchoproliferative process. About 55% of the primary tumors that cause it are of digestive origin, followed by gynecological neoplasms (34%) with the most common histological type being ovarian carcinoma. The diagnostic test of choice is fine needle aspiration to obtain material that allows determining the histopathological and immunohistochemical characteristics to define the origin of the primary neoplasm.