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Sister Mary Joseph’s Nodule

      A 78-year-old woman presented with epigastric pain, melena, and weight loss. There was a slight protuberance in her umbilical region (Figure). Computed tomographic scan showed thickening of the wall of the stomach and an umbilical mass (see the arrow in the Supplemental Figure, available online at http://www.mayoclinicproceedings.org). In this patient, esophagogastroduodenoscopy revealed a gastric mass and histopathology confirmed gastric adenocarcinoma. Pathological evaluation of the umbilical nodule showed metastatic deposits of well-differentiated adenocarcinoma.
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      FigureBlack umbilical node with a small ulcer.
      Metastatic cancer of the umbilicus, known as Sister Mary Joseph’s nodule, refers to a palpable nodule bulging into the umbilicus as a result of metastatic gastrointestinal tract or ovarian cancer. Sister Mary Joseph (1856-1939) was the first administrator of Saint Mary’s Hospital of Mayo Clinic. She noted the association between metastatic intraabdominal cancer confirmed at operation and paraumbilical nodules observed during skin preparation for operation.

      Supplemental Online Material