Sister Mary Joseph Nodule

Main sites of metastases for some common cance...

Main sites of metastases for some common cancer types. Primary cancers are denoted by “…cancer” and their main metastasis sites are denoted by “…metastases”. List of included entries and references is found on main image page in Commons: (Photo credit: Wikipedia)

Sister Mary Joseph Dempsey (born Julia Dempsey; 1856-1939) was the surgical assistant of William J. Mayo at St. Mary’s Hospital in Rochester, Minnesota,USA from 1890 to 1915. She drew Mayo’s attention to the phenomenon, and he published an article about it in 1928. The eponymous term Sister Mary Joseph nodule was coined in 1949 by Hamilton Bailey.

What is Sister Mary Joseph Nodule?

Sister Mary Joseph nodule or node, also called Sister Mary Joseph sign, refers to a palpable nodule bulging into the umbilicus as a result of metastasis of a malignant cancer in the pelvis or abdomen.

Etiology

1.Gastrointestinal malignancies account for about half of underlying sources (most commonly gastric cancer, colonic cancer or pancreatic cancer, mostly of the tail and body of the pancreas)

2.Gynecological cancers account for about 1 in 4 cases (primarily ovarian cancer and also uterine cancer).

3.Unknown primary tumors and rarely, urinary or respiratory tract malignancies cause umbilical metastases.

Mechanism of spread

Proposed mechanisms for the spread of cancer cells to the umbilicus include direct transperitoneal spread, via the lymphatics which run alongside the obliterated umbilical vein, hematogenous spread, or via remnant structures such as the falciform ligament, median umbilical ligament, or a remnant of the vitelline duct.

Importance of the finding

Sister Joseph nodule is associated with multiple peritoneal metastases and a poor prognosis.So once you find a Sister Mary Joseph nodule in a patient you can brace for a bad outcome.
Source:Medcosmos surgery

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