Introduction The Sister Mary Joseph’s nodule is the eponym for metastatic involvement of the umbilicus. This less common entity is the sign of disseminated malignant disease and is usually associated with a poor prognosis, despite increasingly significant means and progress in treatment options. The majority of cases originate from gastrointestinal or ovarian cancer, pancreatic origin is exceptional. Few cases have been reported in the medical literature. This is why it seems appropriate to report the observations of this skin lesion following a pancreatic and colonic adenocarcinoma
Case presentation
- Case 1: Our first case involved a 70-year-old female, of Berber origin, who presented an erythematous and firm subcutaneous umbilical nodule, that measuring 2 cm in diameter. The diagnosis of well-differentiated metastatic adenocarcinoma was established by fine needle aspiration cytology. Due to this cytopathological finding, thoraco-abdominal CT scan was performed. The exam showed a pancreatic process and the diagnosis of umbilical metastasis of pancreatic origin was confirmed by histological study of nodule’s biopsy.
- Case 2: A 38-year-old female, of arabic origin, presented with growing, painless and firm umbilical nodule measuring 3 cm in diameter. Pathologic examination of percutaneous biopsy specimen with immunohistochemical study showed well-differentiated adenocarcinoma with characteristics of colorectal origin. CT of the abdomen coupled with colonoscopy confirmed the colonic origin with bilateral ovarian metastases.
Conclusion An umbilical nodule may be the first sigh of a malignant disease. Therefore, clinical evaluation and biopsy of all nodular lesions of the umbilicus should be performed for therapeutic and pronostic purposes