{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T11:10:35Z","timestamp":1784373035329,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2008,1,15]],"date-time":"2008-01-15T00:00:00Z","timestamp":1200355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2008,2]]},"abstract":"<jats:p><jats:bold>Case 1<\/jats:bold> A 54\u2010year\u2010old woman presented with a 5\u2010month history of an asymptomatic, 2.5\u2010cm, erythematous, ulcerated nodule involving the umbilicus (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#f1\">Fig.\u00a01<\/jats:ext-link>). Biopsy demonstrated metastatic adenocarcinoma (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#f2\">Fig.\u00a02<\/jats:ext-link>) and abdominal ultrasound showed a large ovarian tumor (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#t1\">Table\u00a01<\/jats:ext-link>). Further evaluation revealed pleural metastases.<\/jats:p><jats:p><jats:fig><jats:caption><jats:p>Erythematous nodule of the umbilicus<\/jats:p><\/jats:caption><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" position=\"anchor\" xlink:href=\"urn:x-wiley:00119059:media:IJD3434:IJD_3434_f1\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:fig><\/jats:p><jats:p><jats:fig><jats:caption><jats:p>Proliferation of glandular structures composed of tumor cells with prominent nucleoli and numerous mitoses (hematoxylin and eosin, \u00d74000)<\/jats:p><\/jats:caption><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" position=\"anchor\" xlink:href=\"urn:x-wiley:00119059:media:IJD3434:IJD_3434_f2\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:fig><\/jats:p><jats:p><jats:table-wrap>\n\n<jats:caption><jats:title>Primary malignancy in five patients with Sister Mary Joseph's nodule<\/jats:title><\/jats:caption>\n\n<jats:table frame=\"hsides\">\n<jats:col\/>\n<jats:col\/>\n<jats:col\/>\n<jats:col\/>\n<jats:thead>\n<jats:tr>\n<jats:th> <jats:bold>Case<\/jats:bold> <\/jats:th>\n<jats:th> <jats:bold>Age (years)<\/jats:bold> <\/jats:th>\n<jats:th> <jats:bold>Gender<\/jats:bold> <\/jats:th>\n<jats:th> <jats:bold>Primary malignancy<\/jats:bold> <\/jats:th>\n<\/jats:tr>\n<\/jats:thead>\n<jats:tbody>\n<jats:tr>\n<jats:td>1<\/jats:td>\n<jats:td>54<\/jats:td>\n<jats:td>Female<\/jats:td>\n<jats:td>Ovarian adenocarcinoma<\/jats:td>\n<\/jats:tr>\n<jats:tr>\n<jats:td>2<\/jats:td>\n<jats:td>58<\/jats:td>\n<jats:td>Male<\/jats:td>\n<jats:td>Colorectal adenocarcinoma<\/jats:td>\n<\/jats:tr>\n<jats:tr>\n<jats:td>3<\/jats:td>\n<jats:td>42<\/jats:td>\n<jats:td>Male<\/jats:td>\n<jats:td>Pancreatic adenocarcinoma<\/jats:td>\n<\/jats:tr>\n<jats:tr>\n<jats:td>4<\/jats:td>\n<jats:td>58<\/jats:td>\n<jats:td>Male<\/jats:td>\n<jats:td>Ileocecal sarcoma<\/jats:td>\n<\/jats:tr>\n<jats:tr>\n<jats:td>5<\/jats:td>\n<jats:td>58<\/jats:td>\n<jats:td>Female<\/jats:td>\n<jats:td>Cholangiocarcinoma<\/jats:td>\n<\/jats:tr>\n<\/jats:tbody>\n<\/jats:table>\n\n<\/jats:table-wrap><\/jats:p><jats:p><jats:bold>Case 2\u2002<\/jats:bold> A 58\u2010year\u2010old man was hospitalized with a 6\u2010month history of diffuse abdominal pain, a 2\u2010week history of a cutaneous nodule, and a 5\u2010day history of bloody diarrhea. Cutaneous examination revealed a 1.5\u2010cm, erythematous to violaceous, infiltrative, and verrucous nodule of the umbilicus (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#f3\">Fig.\u00a03<\/jats:ext-link>). Colonoscopy showed a pedunculated polyp of the right colon and a loss of substance in the anal area; histologic examination demonstrated well\u2010differentiated adenocarcinoma. Abdominal ultrasound showed moderate ascites. A diagnosis of colorectal adenocarcinoma (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#t1\">Table\u00a01<\/jats:ext-link>) with umbilical metastasis and peritoneal carcinomatosis was made.<\/jats:p><jats:p><jats:fig><jats:caption><jats:p>Irregular, infiltrative, verrucous nodule of the umbilicus<\/jats:p><\/jats:caption><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" position=\"anchor\" xlink:href=\"urn:x-wiley:00119059:media:IJD3434:IJD_3434_f3\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:fig><\/jats:p><jats:p><jats:bold>Case 3\u2002<\/jats:bold> A 42\u2010year\u2010old man, with a history of surgery 5\u00a0months earlier for a perforated gastric ulcer, was hospitalized with a 2\u2010month history of abdominal pain and general deterioration. Clinical examination showed a 15\u2010cm infiltrative area at the central abdomen with coalescing ulcerated papules at the umbilicus (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#f4\">Fig.\u00a04<\/jats:ext-link>), which developed during the onset of abdominal pain. Histologic evaluation revealed metastatic adenocarcinoma to the skin. Further evaluation supported a diagnosis of pancreatic cancer with peritoneal carcinomatosis (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#t1\">Table\u00a01<\/jats:ext-link>).<\/jats:p><jats:p><jats:fig><jats:caption><jats:p>Tumor infiltrating the central abdomen, with overlying umbilical nodule<\/jats:p><\/jats:caption><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" position=\"anchor\" xlink:href=\"urn:x-wiley:00119059:media:IJD3434:IJD_3434_f4\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:fig><\/jats:p><jats:p><jats:bold>Case 4\u2002<\/jats:bold> A 58\u2010year\u2010old man presented with a 3\u2010month history of abdominal pain and a 1\u2010month history of a painful, bilobed nodular lesion involving the umbilicus. Clinical examination showed a nontender, uniform, and fixed abdominal mass. Colonoscopy revealed a cecal mass. Histologic examination of the cecal mass and umbilical lesion confirmed a diagnosis of ileocecal sarcoma (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#t1\">Table\u00a01<\/jats:ext-link>). Further evaluation demonstrated peritoneal metastases.<\/jats:p><jats:p><jats:bold>Case 5\u2002<\/jats:bold> A 58\u2010year\u2010old woman was hospitalized with a 1\u2010year history of an umbilical lesion, abdominal pain, vomiting, and general deterioration. Examination revealed a 2\u2010cm hard, fixed, nontender, umbilical tumor and hepatomegaly. Endoscopy showed a gastric ulcer without histologic evidence of malignancy. Additional evaluation demonstrated a gallbladder tumor, hepatic metastases, and peritoneal carcinomatosis (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#t1\">Table\u00a01<\/jats:ext-link>). Biopsy of the umbilical lesion revealed poorly differentiated adenocarcinoma.<\/jats:p>","DOI":"10.1111\/j.1365-4632.2008.03434.x","type":"journal-article","created":{"date-parts":[[2009,9,17]],"date-time":"2009-09-17T12:00:11Z","timestamp":1253188811000},"page":"134-136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Sister Mary Joseph's nodule: report of five 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