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Year : 2009  |  Volume : 5  |  Issue : 2  |  Page : 127-129

Sister Mary Joseph nodule as the presenting sign of disseminated prostate carcinoma

1 Department of Pathology, Military Hospital, Udhampur, Jammu & Kashmir, India
2 Department of Urology, Military Hospital, Udhampur, Jammu & Kashmir, India
3 Department of Medicine, Government Medical College, Chandigarh, India

Correspondence Address:
Prabal Deb
Department of Pathology, Armed Forces Medical College, Pune - 411 040
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.52793

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Sister Mary Joseph's nodule is referred to as metastasis of visceral malignancy to the umbilicus. Most common primaries are in the gastrointestinal or genital tract, while other locations are rare. We recently encountered a 76-year-old male who was referred to the surgery clinic with an erythematous nodule in the umbilicus measuring 6 cm in diameter with complaints of painless profuse hematuria. History revealed severe obstructive voiding symptoms of 2-year duration, along with significant loss of weight and difficulty in walking. A detailed examination showed hard nodular hepatomegaly, along with grade IV prostatomegaly. Serum prostate-specific antigen was 3069 ng/ml. A pelvic radiograph displayed multiple osteolytic lesions, while ultrasonography showed multiple iso- and hypoechoic lesions in both lobes of the liver, suggestive of metastasis. Histopathology of a Tru-cut biopsy of the prostate confirmed an adenocarcinoma (Gleason score 9) with umbilical metastasis. The patient was on regular follow-up and died 3 months later.

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