Sister Mary Joseph’s nodule”: first sign of metastatic pancreatic tumor.

Resumen Presentamos el caso de una paciente de 54 años que consultó por dolor y distensión abdominal inespecíficos, siendo finalmente diagnosticada de neoplasia pancreática en estadio avanzado. A la exploración física, destacaba un nódulo umbilical de 3 meses de evolución. El nódulo umbilical "de la hermana María José" es un nódulo metastásico asociado a tumores digestivos y ginecológicos avanzados. En ocasiones, será el único signo de estas enfermedades y es preciso un alto índice de sospecha para un diagnóstico precoz con objetivo de mejorar el pronóstico de estos pacientes.

Sister Mary Joseph’s Nodule: An important Physical Finding.

Background: Sister Mary Joseph’s nodule is a rare but important physical finding as it is a sign of an advanced stage of malignancy.Case presentation: This is a case of an apparently clinically well but immunodeficient 62-year- old African woman whose main complaint was an enlarging violaceous discharging umbilical nodule. A focused history and physical examination complemented by an abdominal computerized tomography (CT) scan was suggestive of an umbilical cutaneous manifestation (Sister Mary Joseph’s nodule) of an underlying disseminated ovarian malignancy. This was confirmed histologically by an excision biopsy of the umbilical nodule.Conclusions: Sister Mary Joseph’s nodule is an important differential diagnosis for an umbilical nodular lesion as it is a sign of advanced malignancy with a generally poor prognosis.