Sister Mary Joseph nodule

Learning points for clinicians Sister Mary Joseph nodule can be as the first signal of advanced intra-abdominal malignancy. It could be easily mistaken for omphalitis, cyst, hernia and skin disease, which leads to the delayed finding of primary tumors. Umbilical nodule in an adult patient should be considered as metastasis until proven otherwise. A 53-year-old man with known stage IV bladder cancer, diagnosed in 2011, was admitted to the hospital for progressive fatigue and diffuse abdominal pain. In 2011, abdominal CT scan revealed a tumor (5.9 × 6.4 cm) in the bladder with muscle-layer invasion, abutting the right internus muscle, and right …