Sister Mary Joseph's nodule – clinical aspects, pathophysiology and therapeutic possibilities
Keywords:
Sister Mary Joseph nodule, umbilical skin metastasis, peritoneal neoplasms, abdominal metastases, gastrointestinal neoplasms, ovarian neoplasms, therapyAbstract
Sister Mary Joseph's nodule (SMJN) is a rare form of umbilical skin metastasis, occurring in approximately 1-3% of patients with intraabdominal or pelvic malignant tumors. The most common primary sources are adenocarcinomas of the stomach, ovaries, colon, and pancreas. Metastases reach the umbilicus through various mechanisms – direct peritoneal invasion, lymphogenic or hematogenic dissemination, and through embryonic remnants such as the urachus, umbilical vein, and falciform ligament. SMJN is often the first visible manifestation of occult malignancy and serves as an important clinical indicator of advanced disease. It is characterized by an unfavorable prognosis and a median survival of less than 12 months. Timely recognition is essential for early diagnosis and planning a multidisciplinary therapeutic approach.
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Journal Bulgarian Medical Journal (Български медицински журнал / Bulgarian Medical Journal)