["Sister Joseph's module"--umbilical metastases of internal tumors]

A 50-year-old man, who was otherwise asymptomatic, presented with an umbilical metastasis of a pancreatic adenocarcinoma. Umbilical metastases ("Sister Joseph's nodule") of internal malignancies are rare. Although they may be the first sign of the underlying malignancy, their appearance is generally correlated with a poor prognosis. Among approximately 400 cases reported in the literature, the most frequent primary tumors were carcinomas of the stomach, ovary, large intestine and pancreas.