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Jornal Português de Gastrenterologia
Print version ISSN 0872-8178
Abstract
MURINELLO, António et al. Sister Mary Josephs nodule. J Port Gastrenterol. [online]. 2010, vol.17, n.6, pp.266-270. ISSN 0872-8178.
A religious nurse at Mayo Clinic, firstly noticed the relationship of umbilical metastatic nodes (Sister Mary Josephs nodule) with advanced inoperable intraabdominal malignancy (ovary, colon, stomach, pancreas, uterus), meaning an unfavourable prognosis. We present a patient with disseminated colonic neoplasm with umbilical metastasis, initially diagnosed as umbilical hernia. A review is performed of: umbilicus anatomy and its attachments containing remnants of fetal structures; its arterial, venous and lymphatic supply, helping to explain why umbilical metastasis occurs; sources of primary malignancy. Clinical, radiological, cytological and histological aspects of the patient´s diagnosis are reviewed. Some patients may have better survival with aggressive surgery and adjunctive chemotherapy, but usually treatment is frequently palliative.
Keywords : Sister Mary Joseph's nodule; colon cancer; umbilical metastasis.