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Case Reports
. 2022 Oct 16;14(10):e30344.
doi: 10.7759/cureus.30344. eCollection 2022 Oct.

Sister Mary Joseph's Nodule From Renal Cell Carcinoma: A Case Report

Kimiko Hirata  1 , Masaru Narabayashi  1 , Takaya Murashima  2 , Takehiko Segawa  2 , Shuji Ohtsu  1
Affiliations
Case Reports

Sister Mary Joseph's Nodule From Renal Cell Carcinoma: A Case Report

Kimiko Hirata et al. Cureus. .

Abstract

Sister Mary Joseph's nodules (SMJNs) are umbilical skin metastases of various abdominopelvic malignancies, and they rarely originate from renal cell carcinomas. Radiotherapy is typically used to treat the nodules as a palliative intention. We report a rare case of SMJN that originated from clear cell renal cell carcinoma, which was treated with external beam radiation therapy (EBRT) and interstitial brachytherapy (ISBT). A 74-year-old male patient with a history of left renal cell carcinoma developed an umbilical nodule which was diagnosed as SMJN. The patient underwent EBRT (30 Gy in 10 fractions) and ISBT (12 Gy in two fractions), leading the nodule to complete resolution. This case report might support that radiotherapy, including ISBT, is effective for the treatment of SMJN from renal cell carcinoma.

Keywords: interstitial brachytherapy; palliative radiotherapy; renal cell carcinoma; sister mary joseph’s nodule; umbilical skin metastasis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Picture of Sister Mary Joseph’s nodule (SMJN)
The picture taken six months after the diagnosis of SMJN shows the umbilical nodule which was black and soft measuring approximately 30 mm.
Figure 2
Figure 2. Computed tomography (CT) images of Sister Mary Joseph’s nodule
The CT images show the umbilical nodule in (A) and (B) marked by red arrows. A peritoneal dissemination nodule is also depicted in (B) marked by the yellow arrow.
Figure 3
Figure 3. Treatment plan for radiotherapy
The dosage distribution of external beam irradiation (A) and that of the first interstitial brachytherapy (B).
Figure 4
Figure 4. Pictures showing changes in Sister Mary Joseph’s nodule
The umbilical nodule at 10 days (A), one month (B), two months (C), and four months (D) after the second interstitial brachytherapy.
See this image and copyright information in PMC

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