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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of Sister Mary Joseph's nodule (umbilical metastases) are presented. The probable primary tumor in all three cases was an ovarian adenocarcinoma. Fine needle aspiration (FNA) was used to confirm the secondary nature of the umbilical lesion in one case. The entity is named after Sister Mary Joseph, who was Superintendent at the Mayo Clinic in the early part of this century. The primary lesion is most commonly found in the genital or gastrointestinal tracts. Since the prognosis for this lesion is extremely poor, with a mean survival of a few months, surgery is usually not indicated; FNA is recommended as a convenient means of confirming the suspected diagnosis.
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PMID:Sister Mary Joseph's nodule. Diagnosis of umbilical metastases by fine needle aspiration. 195 Mar 36

Thirty-eight cases diagnosed by fine needle aspiration as cutaneous/subcutaneous deposits from internal carcinomas were analyzed. Eighteen patients had undergone previous surgery for primary neoplasms in the breast (9 cases), prostate (1), kidney (1), ovary (1), rectum (3), cervix (1), cheek (1) and periampullary region (1). The metastatic deposits in these cases occurred 1-42 months following removal of the primary neoplasm. Sixteen patients had metastatic deposits occurring simultaneously with the primary tumor in the lung (4 cases), pancreas (1), stomach (3), esophagus (1), ovary (1), rectum (1) anal canal (1), maxillary antrum (1), gallbladder (1), colon (1) and kidney (1). In four patients with metastatic nodules, the primary was undetected in spite of a thorough clinical examination and laboratory investigations. There were five cases of Sister Mary Joseph's nodule (umbilical metastases), four from primary cancer in the abdomen and one in which the primary remained unknown. The deposits were solitary except in one case and were usually less than 2.5 cm in diameter. Adnexal tumor can be a differential diagnosis. Special stains were of little help in such cases, and correlation with the clinical findings was enough to arrive at the diagnosis. Fine needle aspiration provides a rapid morphologic diagnosis in patients with cutaneous/subcutaneous metastatic deposits from internal carcinoma.
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PMID:Metastatic cutaneous and subcutaneous deposits from internal carcinoma. An analysis of cases diagnosed by fine needle aspiration. 824 9

We describe an unusual case of colon cancer presenting with two dermatologic manifestations of internal malignancies: Trousseau's syndrome and Sister Mary Joseph's nodule. Trousseau's syndrome is associated with 1 to 11 percent of internal malignancies, while 5 percent of colorectal carcinomas present with cutaneous metastases. Our case highlights the clinical significance of dermatologic signs of occult gastrointestinal malignancies.
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PMID:Adenocarcinoma of the colon presenting with a Sister Mary Joseph's nodule and Trousseau's syndrome. 856 11

A 72-year-old woman presented with a progressively enlarging, painful umbilical nodule. A biopsy specimen of the lesion showed focally mucin-producing adenocarcinoma, and the patient was diagnosed to have metastatic carcinoma of umbilicus: Sister Mary Joseph's nodule. Search for the primary tumor revealed adenocarcinoma of the splenic flexure of colon with metastasis to liver, spleen, and periaortic lymph nodes. Sister Mary Joseph's nodule is a well-known entity. It is a rare form of cutaneous umbilical metastases, can present as the first sign of intra-abdominal malignancy, carries very poor prognosis, and generally is inoperable. This report emphasizes the need for careful evaluation of any umbilical lesion and the importance of histologic diagnosis in case of doubt.
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PMID:Metastatic carcinoma of umbilicus: "Sister Mary Joseph's nodule". 942 70

BACKGROUND: Umbilical metastases from a malignant neoplasm, also termed Sister Mary Joseph's nodule, are not commonly reported in the English literature, and they have usually been considered as a sign of a poor prognosis for the patient. The present article reports on the current view point on umbilical metastasis besides discussing the epidemiology, clinical presentation, pathophysiology and treatment. METHOD: A search of Pubmed was carried out using the term 'umblic*' and 'metastases' or metastasis' revealed no references. Another search was made using the term "Sister Joseph's nodule" or sister Joseph nodule" that revealed 99 references. Of these there were 14 review articles, however when the search was limited to English language it yielded only 20 articles. Articles selected from these form the basis of this report along with cross references. RESULTS: The primary lesions usually arise from gastrointestinal or genitourinary tract malignancies and may be the presenting symptom or sign of a primary tumour in an unknown site. CONCLUSION: A careful evaluation of all umbilical lesions, including an early biopsy if appropriate, is recommended. Recent studies suggest an aggressive surgical approach combined with chemotherapy for such patients may improve survival.
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PMID:Umbilical metastases: current viewpoint. 1572 95

Micropapillary serous carcinomas (MPSCs) have been distinguished from typical ovarian serous borderline tumors. Although the clinical features of MPSCs have been described in several studies, there is almost no clinicopathologic information regarding stage IV MPSC patients. We describe three cases of stage IV invasive MPSC with clinical and pathologic findings. One case had an umbilical metastasis (Sister Mary Joseph's nodule), and the other two cases had cytologically positive pleural effusions. These cases demonstrate the potential of MPSCs for aggressive clinical behavior and distant metastases.
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PMID:Stage IV micropapillary serous ovarian carcinoma: a report of three cases. 1596 98

We present 2 rare cases of umbilical metastases (Sister Mary Joseph's nodule) as the first sign of late recurrent ovarian cancer. Two patients with ovarian cancer treated with optimal debulking surgery plus chemotherapy were regularly followed up postoperatively. An isolated umbilical nodule was noted accidentally 8 years and 3 years, respectively, after the initial operation. Abdominal computed tomography (CT) for both patients showed a 1.8-cm mass and a 2.3-cm mass with negative peritoneal tumor seeding. Other tumor surveys, including CA125, showed negative findings. Both patients had exploratory laparotomy and complete excision of the umbilical tumor. The pathology showed an isolated metastatic adenocarcinoma without evidence of other metastases. Both patients were treated with 4-course postoperative adjuvant chemotherapy of carboplatin and paclitaxel. Both patients have been in complete clinical remission for 22 months and 12 months, respectively. In addition to tumor marker CA125, a careful and thorough physical examination, assisted by modern imaging evaluation, is the best method for detecting early recurrence in patients with previously treated ovarian cancer. Although an umbilical metastasis usually indicates advanced disease with disseminating peritoneal spread, it does not always imply inoperable or incurable disease. Intensive treatment can improve the outcome.
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PMID:Umbilicus as the only site of metastasis in recurrent ovarian cancer. 1683 87

Sister Mary Joseph (1856-1939), who was superintendent nurse at St. Mary's Hospital in Rochester, Minnesota, U.S.A. (at present Mayo Clinic), observed that patients with intra-abdominal or pelvic malignancy often had an umbilical nodule. In 1949 the English surgeon Hamilton Bailey, in his famous textbook "Demonstrations of Physical Signs in Clinical Surgery", coined the term "Sister Joseph's nodule" for umbilical metastases. To date, more than 400 cases of Sister Mary Joseph's nodule have been described in the literature. The nodule may be painful and ulcerated, sometimes with pus, blood, or serous fluid. It is usually a firm nodule measuring 0.5-2 cm, although some nodules may reach up to 10 cm in size. Tumor may spread to the umbilicus through lymph ducts, blood vessels, contiguous extension, and embryologic remnants. Sister Mary Joseph's nodule can be the first manifestation of an underlying malignancy or an indication of a recurrence in a patient with a previous malignancy. The most common origin of Sister Mary Joseph's nodule in women is ovarian carcinoma and in men--gastric carcinoma. Sister Mary Joseph's nodule has traditionally been considered a sign of advanced primary malignancy with an associated poor prognosis; the average survival time has been reported to be 11 months with < 15% of the patients surviving >2 years. In some patients, however, depending on the state of the primary neoplasm and the patient's general condition, surgery and/or chemotherapy may improve survival.
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PMID:[Umbilical metastasis: Sister Mary Joseph's nodule]. 1690 Jul 41

Sister Mary Joseph's nodule is referred to as metastatic lesion of the umbilicus. Most of the tumors are adenocarcinomas originating from gastroenteric and genital tracts. Only rarely were metastases from other locations reported. We describe here an unusual case of a Sister Mary Joseph's nodule that was metastasized from prostate carcinoma 3 years after radiation therapy. The lesion was the first sign of metastatic disease, and the diagnosis was made on skin biopsy. The patient died of extensive metastases of prostate carcinoma 4 months later. We report this case to extend the list of differential diagnosis for Sister Mary Joseph's nodule in male patients and emphasize the importance of Sister Mary Joseph's nodule as an ominous diagnostic sign.
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PMID:Umbilical metastasis from prostate carcinoma (Sister Mary Joseph's nodule): a case report and review of literature. 1757 39

We report a case of advanced unresectable pancreatic cancer (cT4N1M0/stage IVa). The patient was a 68-year-old man. Chemo-radiation therapy (CRT) with GEM (1,000 mg/body) was administered once a week on days 1, 8 and 15 for 3 weeks. The radiotherapy dose was 45 Gy (1.5 Gy x 2/day, 15 days). After CRT, the patient was treated with a GEM+ UFT-E combination chemotherapy. When that was done, CT scan revealed metastases of umbilicus (Sister Mary Joseph's nodule) and the liver. Microwave Coagulation Therapy for the liver metastasis and tumorectomy for metastasis of umbilicus were performed. But he died after 4 months from the therapies.
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PMID:[A case of metastases of umbilicus (Sister Mary Joseph's nodule)]. 1910 40


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