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.