Snapshot quiz 17/7

Published: 07/10/2017

Authors: Chia CLK, Cheng A and Lim KT

This 81-year-old woman has locally advanced transverse colonic cancer invading into the anterior abdominal wall. The sign depicted in b is a Sister Mary Joseph’s nodule (SMJN). William Mayo first described the clinical syndrome as ‘pants button umbilicus’ before the term SMJN was coined by Hamilton Bailey¹. SMJN is a cancer deposit in the umbilicus, and the commonest primary neoplasm is of gastrointestinal tract (35–65 per cent), followed by gynaecological (12–35 per cent) origin. A SMJN sign suggests advanced metastatic disease and has a poor prognosis.

References
1 Mayo WJ. Metastasis in cancer. Proceedings of the Staff Meetings of the Mayo Clinic 1928; 3: 27.