{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T06:20:37Z","timestamp":1780122037765,"version":"3.54.0"},"reference-count":10,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,5,15]]},"published-print":{"date-parts":[[2019,5,31]]},"abstract":"<jats:p>Sister Mary Joseph (SMJ) nodules are rare malignant metastatic umbilical nodules, indicating disseminated disease and associated with a poor prognosis. This is the case of an 80-year-old woman who presented with umbilical discomfort and an ulcerated umbilical nodule. She was noted to have a bulky uterus and vaginal bleeding. CT abdomen-pelvis showed an enlarged uterus and right-sided lymphadenopathy, extending from the groin to the para-aortic area. Upper and lower endoscopies were normal. Biopsy of the umbilical nodule revealed metastatic endometrioid adenocarcinoma grade 1\u20132 with the endometrium and the ovary suggested as potential primary sites. The patient had cytoreductive surgery including en bloc resection of the umbilical tumour. Final histology confirmed Stage IVb endometrioid adenocarcinoma of the uterus. This unusual case highlights the diagnostic challenges faced with the presentation of an umbilical nodule. Gynaecological malignancy should always be considered within the initial differential diagnosis of an SMJ nodule.<\/jats:p>","DOI":"10.1136\/bcr-2019-229187","type":"journal-article","created":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T07:45:15Z","timestamp":1559375115000},"page":"e229187","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Sister Mary Joseph nodule: an unusual site for endometrioid cancer metastasis"],"prefix":"10.1136","volume":"12","author":[{"given":"Sarah","family":"Petch","sequence":"first","affiliation":[{"name":"Department of Gynaecology, Tallaght Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Sobota","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynaecology, Coombe Women and Infants University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feras","family":"Abu Saadeh","sequence":"additional","affiliation":[{"name":"Department of Gynaecology-Oncology, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,5,31]]},"reference":[{"key":"2025082707405454000_12.5.e229187.1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp13X673900"},{"key":"2025082707405454000_12.5.e229187.2","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3747\/co.v17i6.684","article-title":"Umbilical metastasis: a case series of four Sister Joseph nodules from four different visceral malignancies","volume":"17","author":"Palaniappan","year":"2010","journal-title":"Curr Oncol"},{"key":"2025082707405454000_12.5.e229187.3","first-page":"385","article-title":"Sister mary joseph nodule-a case report with review of literature","volume":"14","author":"Dar","year":"2009","journal-title":"J Res Med Sci"},{"key":"2025082707405454000_12.5.e229187.4","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s10029-011-0863-4","article-title":"Prevalence of adult paraumbilical hernia. 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