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Case Reports
. 2019 May;81(2):325-329.
doi: 10.18999/nagjms.81.2.325.

A long-term survival case of Sister Mary Joseph's nodule caused by colon cancer and treated with a multidisciplinary approach

Yoshinori Iwata  1   2 , Takashi Kinoshita  1 , Kenya Kimura  1 , Koji Komori  1 , Daisuke Hayashi  1 , Tomoyuki Akazawa  1 , Itaru Shigeyoshi  1 , Masayuki Tsutsuyama  1 , Jiro Kawakami  1 , Akira Ouchi  1 , Seiji Natsume  1 , Norihisa Uemura  1 , Yuichi Ito  1 , Kazunari Misawa  1 , Yoshiki Senda  1 , Tetsuya Abe  1 , Seiji Ito  1 , Masahiro Tajika  3 , Yasushi Yatabe  4 , Kazuhiro Yoshida  2 , Yasuhiro Shimizu  1
Affiliations
Case Reports

A long-term survival case of Sister Mary Joseph's nodule caused by colon cancer and treated with a multidisciplinary approach

Yoshinori Iwata et al. Nagoya J Med Sci. 2019 May.

Abstract

Umbilical metastasis from intra-abdominal or pelvic malignancy, which is called Sister Mary Joseph's nodule (SMJN), is rare, and it has a poor prognosis. Its most common primary sites are the stomach and ovaries. SMJN caused by colon cancer is uncommon. A 42-year-old woman visited local clinics with complaints of an umbilical mass. After a detailed examination, she was diagnosed with peritoneal and umbilical metastasis caused by colon cancer. A radical surgery was performed after 12 months of chemotherapy. 6 months later, local recurrence and ovarian metastasis were suspected. Further radical surgery was performed, and 14 months after that (50 months after starting treatment), no recurrences have been observed. We experienced a long-term survival case of SMJN caused by colon cancer and treated with a multidisciplinary approach.

Keywords: Sister Mary Joseph’s nodule; colon cancer; multidisciplinary treatment; umbilical metastasis.

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Conflict of interest statement

The authors have no conflicts of relevant financial interests.

Figures

Fig. 1
Fig. 1
A contrast-enhanced CT findings before treatment. CT showed ascending colon wall thickening (a), mesenteric lymph nodes swelling (a), an umbilical tumor lesion (b) and an intraperitoneal nodule (c).
Fig. 2
Fig. 2
A contrast-enhanced CT findings after chemotherapy. All lesions had shrunk or showed no change (a, b, c).
Fig. 3
Fig. 3
Histopathological examination findings. Histopathological examination showed moderate adenocarcinoma in the ascending colon (a) and umbilical tumor (b).
Fig. 4
Fig. 4
FDG-PET findings. FDG-PET showed high accumulation on the anastomosis (a) and right ovary (b).
See this image and copyright information in PMC

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