An Interesting Case of Sister Mary Joseph's Nodule Revealed by ¹⁸F-FDG PET

The Sister Mary Joseph's nodule is a rare umbilical metastatic lesion, occurring in 1%-3% of abdominopelvic adenocarcinomas. It represents the visible tip of the iceberg, and its presence is associated with a poor prognosis. We report the case of a 61-year-old postmenopausal female patient with rectosigmoid adenocarcinoma. An ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET) scan revealed, in addition to a large sigmoid mass, multiple hypermetabolic lumbo-aortic lymphadenopathies, secondary hypermetabolic pulmonary and hepatic nodules, and a large subcutaneous umbilical nodule consistent with a Sister Marie Joseph's nodule. This case supports the systematic use of ¹⁸F-FDG PET in oncologic evaluations involving suspicious umbilical nodules.