The first reports of this clinical sign were from walshe in 1846. The first medical report of metastasis to the umbilicus due to visceral carcinomas was done by walshe et al. Hamilton bailey in his book physical signs in clinical surgery, in honor of sister mary joseph. The presence of sister mary joseph s nodule is a sign of advanced malignancy and generally indicates a poor prognosis.
The 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. Feb 22, 2009 sister mary joseph nodule is associated with multiple peritoneal metastases and signifies a poor prognosis. Primary peritoneal carcinoma presenting as a sister mary. Pdf sonographic findings of sister mary josephs nodule. Sister mary josephs nodule is referred to a metastatic lesion of the umbilicus originating from intraabdominal or pelvic malignant disease. A rare case of sister mary joseph nodule, manifesting as ascites, cachexia and bleeding per rectum, is presented without any primary tumor despite extensive search for the same. Umbilical metastases usually indicate advanced disease. Metastasis to the umbilicus, known as a sister mary joseph nodule, in a patient with metastatic ovarian cancer this case was donated to by. Sister mary joseph dempsey born julia dempsey was a catholic nun and surgical assistant of william j. It was named after sister mary joseph, a surgical assistant to dr. The eponymous term sister mary joseph nodule was coined in 1949 by hamilton bailey. That was my first indication that i had ovarian cancer. We present a case of an 87yearold patient with sister mary joseph s nodule metastasis caused by a primary peritoneal malignancy. An umbilical metastatic lesion is called sister mary joseph s nodule.
The term sister joseph s nodule first was used in sir hamilton baileys famous textbook demonstrations of physical signs in clinical surgery in 1949. What is sister mary joseph nodule of the umbilicus. This is an important clinical sign, as it indicates that a cancer has not only developed, but spread beyond the original site. For patients who have a sister mary joseph nodule, the prognosis can be poor. The illustration is of a 70 year old lady who presented with some irritation and papules within the umbilicus and patchy erythematous areas on adjacent skin lymphangitis carcinomatosa. It is commonly caused by gastrointestinal and ovarian cancer. Sister mary joseph nodule also called sister mary joseph node or sign. In medicine, the sister mary joseph nodule or more commonly node, also called sister mary joseph sign, refers to a palpable nodule bulging into the umbilicus as a result of metastasis of a. Sister mary joseph nodule definition of sister mary joseph. Its probably clear from the above links, but i thought id stop by to say that there is no relation whatever between hiatal hernia and sister mary joseph s sign. The authors report a case of sister mary josephs nodule as the first sign of internal. They have access to many colleagues in the department and world wide. The presumed final diagnosis was primary peritoneal carcinoma presenting at the umbilicus, and the recommendation was for adjuvant chemotherapy with carboplatin and paclitaxel.
Oct 15, 2015 sister mary joseph was the first to note the association between paraumbilical nodules observed during skin preparation for surgery and metastatic intraabdominal cancer confirmed at surgery 15. Sister mary joseph nodule is an eponym assigned to a nurse, first reported. Sister mary joseph nodule an overview sciencedirect topics. She was the first to draw attention to this observation and in 1929, dr. She pointed out to him the frequent finding of a nodule in the umbilicus of patients with advanced malignancy, and he subsequently published a paper on the topic. Mary s hospital in rochester, minnesota from 1890 to 1915. The eponym sister mary joseph s nodule has been used by generations of physicians. Sister mary joseph dempsey american nurse britannica. Disappearance of sister mary joseph nodule inspire. Sister mary joseph s nodule metastasis is a rather rare finding. Sister joseph nodule definition of sister joseph nodule by. The case outlined in this study demonstrates a rare presentation of primary peritoneal carcinoma as an umbilical lesion, or sister mary joseph s nodule.
Sister mary joseph nodule or node refers to a palpable nodule bulging into the umbilicus and is usually a result of a malignant cancer in the pelvis or abdomen. Epidemiology umbilical metastases are uncommon, reportedly present in % of all intraabdominal a. Presented in part at the national clinical dermatology conference, american academy of dermatology, chicago, il, june 23 to 26, 1983. The primary tumour is classically one of the stomach, large bowel, or tail of the pancreas, although about 25% are of gynaecological origin. A sister mary joseph nodule is a metastatic lesion involving the umbilicus. My mother is a stage 4 breast cancer patient with bone marrow involvement. In 14% of cases, a sister mary joseph nodule was the initial presentation of the internal malignancy. The mechanism of tumor spread to the umbilicus may be lymphatic, vascular or contiguous, or via embryologic remnants in the abdominal wall. The term sister mary josephs nodule was coined by sir hamilton bailey in his book, physical signs in clinical surgery, in honor of sister mary joseph, dr. Sister mary joseph nodule can be as the first signal of advanced. Sister mary josephs nodule typically presents as an umbilical or paraumbilical nodule with a firm consistency, varying in size between 0. In 1949, british surgeon, henry hamilton bailey published this finding with the term. Sister mary joseph nodule as a first manifestation of a. Marys hospital in rochester, minnesota from 1890 to 1915.
It is a rare condition and can be a presenting symptom of undiagnosed underlying malignancy, or a symptom or sign of disease progression or recurrence in a known patient. The sister mary josephs nodule is a periumbilical metastatic tumor. The nodular umbilical metastatic lesion has been termed the sister mary joseph nodule from the departments of dermatology and pathology, mayo clinic and mayo foundation. This case report describes an 82yearold female diagnosed with metastatic pancreatic adenocarcinoma presenting with a sister mary josephs nodule. Sister mary josephs nodule smjn, which is known as a malignant tumor metastasized to the umbilicus, is a rare condition.
It is associated with multiple peritoneal metastases and usually indicates an advanced stage of disease with a poor prognosis. We report ultrasonic findings of smjn secondary to ovarian cancer in a. In 1949, sir hamilton bailey used this eponym in his book physical signs in clinical. Sister mary joseph nodule, umbilical metastasis, squamous cervical cancer, peritoneal carcinomatosis. We report three cases of sister mary joseph s nodule. Mayo, who noted the association between the presence of an umbilical nodule and an intraabdominal malignancy. She was the first to note the association between paraumbilical tumors observed.
The most common primary source is an intraabdominal adenocarcinoma. Mayo who described the clinical features of nodular umbilical metastases, sister mary joseph is credited with being the first to appreciate that patients with this finding had a poor prognosis. Image of the monthdiagnosis dermatology jama surgery. Sister mary josephs nodule is a metastatic tumor deposit in the umbilicus and often represents advanced intraabdominal malignancy with dismal prognosis. The primary malignancy in women is usually ovarian, endometrial, gastric, or pancreatobiliary tree cancer. Julia dempsey was an american nurse and hospital administrator born in salamanca, ny in 1856. The patients medical history included arterial hypertension, for which she.
Sister mary joseph nodule of the umbilicus dermnet nz. 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. The purpose of the journal of the belgian society of radiology is the publication of articles dealing with diagnostic and interventional radiology, related imaging techniques, allied sciences, and continuing education. Mar 15, 2020 a sister mary joseph nodule is a lesion around the navel that indicates the metastatic spread of an abdominal cancer. Abdominal cancers, such as bowel cancer, are the most likely source of a sister mary joseph nodule, but these growths can also develop in cases of uterine and other reproductive cancers.
Sister mary josephs nodule refers to a palpable nodule bulging into the umbilicus as result of a malignant cancer in the abdomen or pelvis. The name first was used in hamilton baileys textbook of surgery in 1949. I also had tumors on my liver, spleen, colon and diaphram. Sister mary joseph nodule smjn is a rare umbilical lesion resulting from an intraabdominal andor pelvic malignancy. Originally written up in the 1920s, the sister mary joseph nodule was retroactively named for her in the 1950s to recognize her contribution to the field of medicine. In medicine, the sister mary joseph nodule or more commonly node, also called sister mary joseph sign, refers to a palpable nodule bulging into the umbilicus. Sister mary joseph nodule journal of the belgian society of. Sister mary joseph nodule and peritoneal carcinomatosis from. Sister mary joseph nodule radiology reference article. Sister mary josephs nodule as the sole presenting sign of gastric. Julia dempsey in august 1878 entered the third order regular of st. This eponymous term refers to secondary cancer metastasis appearing in the umbilicus, usually spreading from advanced peritoneal adenocarcinoma.
Francis of the congregation of our lady of lourdes, taking the name sister mary joseph. Joseph in the united states, volume 1, commissioned by the us federation of the sisters of st. Dec 07, 2015 in medicine, the sister mary joseph nodule or more commonly node, also called sister mary joseph sign, refers to a palpable nodule bulging into the umbilicus as a result of metastasis of a. It is a rare but important physical finding as it is a sign of advanced stage of malignancy. Jan 01, 20 sister mary josephs nodule is an eponymous term referring to a malignant metastatic umbilical nodule. Sister mary joseph nodule and peritoneal carcinomatosis from squamous cell cervical carcinoma leila cristina soares,1 juliana procopio almeida 1. She was known for extraordinary skills and judgement. In 1949, sir hamilton bailey used this eponym in his book physical signs in clinical surgery to describe this umbilical metastatic nodule, in honor of sister mary. Us federation releases the history of sisters of st joseph. Sister mary joseph dempsey 18561939 was the surgical assistant to william mayo in the early days of the mayo clinic 8. She drew mayos attention to the phenomenon, and he published an article about it in 1928.
Mary joseph s nodule are those usually of a singular experience published as a case report. Recently, she developed a sister mary joseph nodule near her navel. Sister mary joseph nodule smjn is a cutaneous metastasis of a visceral malignancy to the umbilicus. In the three cases presented, the primary tumor was an adenocarcinona of the sigmoid colon, a carcinoma of the bladder, and an adenocarcinoma of the gallbladder. Mary mcglone unveiled her new book, anything of which woman is capable, the history of the sisters of st.
Umbilical metastasis sister mary josephs nodule, named by hamilton bailey after sister mary joseph, is a rare physical sign encountered in 1. Mar 25, 2020 sister mary joseph dempsey, american nurse and hospital administrator, remembered for her exceptional medical and administrative abilities and for her contributions to nursing education. Oct 15, 2015 a sister mary joseph nodule is a metastatic umbilical deposit. Through a literature search, we also discuss the pathophysiology, diagnostic approach. The sister mary joseph nodule is a manifestation of umbilical metastasis of malignancy typically arising from the gastrointestinal or genitourinary tract. William mayos surgical assistant in the early days of the mayo clinic. Jan 19, 2016 what does sister mary joseph s nodule mean in english. Pdf sister mary josephs nodule refers to a palpable nodule bulging into the. Sister mary josephs nodule at a university teaching hospital. Sister mary josephs nodule refers to a palpable nodule bulging into the umbilicus. It is an uncommon clinical or radiographic finding, and it is rare as the first sign of a malignant disease.