Sister Mary Joseph结节

报告1例可能为胃癌转移的Sister Mary Joseph结节1例.患者男,44岁.脐部出现暗红色大小不等的结节7个月.皮损组织病理检查:真皮全层胶原束间散在呈腺样分化的肿瘤细胞,免疫组化染色:癌胚抗原(CEA)阳性、细胞角蛋白(CK)20阳性、CK7阳性、甲状腺转录因子(TIT)-1阴性.糖链抗原(CA)19-9、CA72-4、CA24-2均升高.腹部B超检查示:胃幽门部胃壁增生性病变,肝右叶多发偏强回声结节,腹水.     

Sister Mary Joseph结节一例

患者,男,52岁。脐部结节8个月。脐部皮损组织病理诊断为皮肤转移性腺癌(Sister Mary Joseph结节),免疫组化染色：细胞角蛋白(CK)20阳性、CK7阴性、尾型同源框转录因子-2(CDX2)阳性。肺部CT示肺转移癌。诊断：Sister Mary Joseph结节。     

Sister Mary Joseph's nodule: report of five cases

Case 1 A 54‐year‐old woman presented with a 5‐month history of an asymptomatic, 2.5‐cm, erythematous, ulcerated nodule involving the umbilicus ( Fig. 1 ). Biopsy demonstrated metastatic adenocarcinoma ( Fig. 2 ) and abdominal ultrasound showed a large ovarian tumor ( Table 1 ). Further evaluation revealed pleural metastases.

Figure 1 Open in figure viewer PowerPoint Erythematous nodule of the umbilicus     

Sister Mary Joseph's nodule as a metastasis of gallbladder carcinoma

Umbilical metastasis, alias Sister Mary Joseph's nodule, is a rare clinical phenomenon. It indicates neoplasm of inner organs mostly located in the gastrointestinum or the pelvis. However, in approximately 15-30% the primary tumor remains occult. In most cases Sister Joseph's nodule appears as an early and sometimes the only symptom of the malignoma. Here we report on an umbilical metastasis of a gallbladder carcinoma with subsequent manifestation of other tumor complications such as extensive thrombosis of arm veins.     

A case of Sister Mary Joseph's nodule from prostatic cancer

The metastasis of a visceral malignancy to the umbilicus is known as "Sister Mary Joseph's nodule" (SMJN). We recently encountered an 80-year-old man in whom umbilical metastasis of prostatic cancer was revealed during the course of treatment. The lesion was a red, firm, elastic nodule, 2.5 cm in diameter, with a bumpy, irregular surface, but without subjective symptoms. In histopathological examination, atypical cells with intensely stained, small quasi-circular nuclei and weakly eosinophilic cytoplasm were found in all layers of the dermis. In some parts of these tumor cells, a gland-like structure was observed. Immunohistochemical investigation of the invading tumor cells disclosed immunoreactivity for prostate specific antigen and prostatic acid phosphatase, supporting a diagnosis of SMJN from prostatic cancer. His general condition gradually deteriorated, and he died 2 months later. Prostate cancer often metastasizes to bones and lymph nodes, but rarely to the skin. Of all the cases of cutaneous metastasis of prostate cancer reported in Japan, only three metastases have occurred to the umbilical region. The present case is therefore an example of a very rare condition.     

Malignant mesothelioma presenting as Sister Joseph's nodule

We report a rare case of malignant peritoneal mesothelioma in which the patient presented with umbilical tumor involvement. This case is also compared with other cases of umbilical neoplasm.     

Umbilical metastasis from prostate carcinoma (Sister Mary Joseph's nodule): a case report and review of literature

Sister Mary Joseph's nodule is referred to as metastatic lesion of the umbilicus. Most of the tumors are adenocarcinomas originating from gastroenteric and genital tracts. Only rarely were metastases from other locations reported. We describe here an unusual case of a Sister Mary Joseph's nodule that was metastasized from prostate carcinoma 3 years after radiation therapy. The lesion was the first sign of metastatic disease, and the diagnosis was made on skin biopsy. The patient died of extensive metastases of prostate carcinoma 4 months later. We report this case to extend the list of differential diagnosis for Sister Mary Joseph's nodule in male patients and emphasize the importance of Sister Mary Joseph's nodule as an ominous diagnostic sign.     

Sister Mary Joseph's nodule: a clue to finding pancreatic cancer in a patient previously affected by gastric cancer

An 82-year-old man with Sister Mary Joseph's nodule (SMJN) is reported. He had a past history of gastric cancer, which had been removed in its early stage. Histopathological findings, in which CA19-9 and other markers, such as PCNA and p53, were strongly positive in SMJN but negative in specimens from the gastric cancer, suggested that the nodule had derived from another internal malignancy and a detailed search led to the discovery of a pancreatic cancer.     

Sister Mary Joseph nodule: a case report

A metastatic malignancy of the umbilicus is commonly termed Sister Mary Joseph nodule (SMJN). It is a rare occurrence but may represent the first sign of a visceral malignancy and therefore should prompt a thorough search for the primary tumor. Typically, the most common origin of an umbilical metastasis is an adenocarcinoma from a gastrointestinal or gynecologic primary malignancy. The presence of SMJN carries a poor prognosis with the average survival time at the appearance of an umbilical metastasis being 10 months. We report a case of a 66-year-old man who was referred for evaluation of an enlarging umbilical lesion. Histopathology revealed adenocarcinoma. After a full metastatic workup, the tumor of origin was identified as adenocarcinoma of the sigmoid colon. Benign tumors of the umbilicus are uncommon. This case report serves to emphasize the importance of obtaining a histologic diagnosis when any new lesion presents in the umbilical region.