Skip to Main Content

7-23: Sister Mary Joseph Node (Nodular Umbilicus)

Kevin S. Barlotta; Lawrence B. Stack; Kevin J. Knoop

Clinical Summary

A Sister Mary Joseph node is a metastasis manifesting as a periumbilical nodule secondary to abdominal or pelvic cancers (one-half are gastrointestinal, one-quarter are gynecologic). Cancers of the colon may cause pain, change in bowel habits, anemia, and obstruction. In general, left-sided cancers cause obstruction, whereas right-sided tumors may have significant metastases before they create signs and symptoms. These metastases typically involve peritoneal and omental spread with distant metastases to the liver. Spread to the umbilicus is colloquially known as the Sister Mary Joseph node.

FIGURE 7.67

Sister Mary Joseph Node. Sister Mary Joseph nodule of a patient with ovarian cancer. (Photo Contributor: Stephen W. Corbett, MD.)

In a patient with a Sister Mary Joseph Node, there is a bulging, round growth emerging from the navel, and a second smaller growth about an inch above it.
View Full Size||Download Slide (.ppt)

Prognosis is poor if cancer is the cause (survival time of 10 months).

Management and Disposition

Prompt referral for staging and treatment of the tumor is indicated. Other signs and symptoms (from obstruction, blood loss, malnutrition, and pain) should be addressed and treated.

Pearls

  1. Virchow node, presenting as a supraclavicular mass, also heralds bowel carcinoma.

  2. A Sister Mary Joseph node is commonly due to gastric carcinoma.

  3. All umbilical masses require evaluation with contrast-enhanced CT scan of the abdomen/pelvis.

FIGURE 7.68

Sister Mary Joseph Node. This 63-year-old woman presents with abdominal swelling and ascites. She was diagnosed with ovarian cancer. Axial CT scan of the abdomen at the level of the umbilicus demonstrates ascitic fluid and the umbilical nodularity (arrows). (Photo contributor: R. Jason Thurman, MD.)

In a patient with a Sister Mary Joseph Node, a bulging round growth emerges from the navel. There is dark discoloration and yellow discharge. An Axial C T scan shows the abdominal organs and a Sister Mary Joseph Node bulge with ascitic fluid at the top center, in the site of the navel.
View Full Size||Download Slide (.ppt)
In a patient with a Sister Mary Joseph Node, a bulging round growth emerges from the navel. There is dark discoloration and yellow discharge. An Axial C T scan shows the abdominal organs and a Sister Mary Joseph Node bulge with ascitic fluid at the top center, in the site of the navel.
View Full Size||Download Slide (.ppt)
FIGURE 7.69

Nodular Umbilicus. Firm umbilical nodule and abdominal distension due to a germ cell tumor. (Photo contributor: Lawrence B. Stack, MD.)

In a patient with a Nodular Umbilicus, there is a firm nodule at the navel with a ridge around it, along with abdominal swelling.
View Full Size||Download Slide (.ppt)
FIGURE 7.70

Nodular Umbilicus—CT. Contrast-enhanced CT of the abdomen/pelvis reveals an umbilical nodule and large mass, which is a germ cell tumor. (Photo contributor: Lawrence B. Stack, MD.)

A contrast-enhanced C T scan image of the abdomen and pelvis shows a V-shaped umbilical nodule and a large round mass over it.
View Full Size||Download Slide (.ppt)

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MH Privacy Center Close