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A pancreas carcinoma metastasis presented as a sore belly button in a 76-year-old man. This rare presentation, known as a Sister Mary Joseph

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Area of Science:

  • Oncology
  • Dermatology
  • Gastroenterology

Background:

  • Metastatic disease can manifest in unusual cutaneous sites.
  • The umbilicus is a rare but recognized site for metastatic deposits.

Observation:

  • A 76-year-old male presented with a 3-week history of an erythematous, symptomatic umbilical lesion.
  • Initial clinical presentation mimicked a localized inflammatory or infectious process.

Findings:

  • Histopathological examination confirmed metastatic adenocarcinoma.
  • Elevated Cancer Antigen 19-9 (CA 19-9) levels supported a pancreatic origin.
  • CT scan revealed a pancreatic mass, consistent with primary carcinoma.

Implications:

  • Umbilical metastases, or Sister Mary Joseph's nodules, can be an early sign of advanced intra-abdominal malignancy, particularly pancreatic cancer.
  • This case highlights the importance of considering metastatic disease in the differential diagnosis of umbilical lesions, even in the absence of typical symptoms.
  • Prompt diagnosis through integrated clinical, radiological, and biochemical evaluation is crucial for patient management and prognosis.