Umbilical Nodule in a Patient With a History of Colon Cancer

A Sister Mary Joseph nodule (SMJN) is a rare cutaneous manifestation of metastatic intra-abdominal or pelvic malignancy and typically indicates advanced disease. We report the case of a 48-year-old female patient who presented to our dermatology clinic with a three-month history of a painless, skin-colored umbilical mass with intermittent foul-smelling serosanguinous drainage. Her medical history was noteworthy for metastatic adenocarcinoma of the colon diagnosed five years earlier, initially treated with subtotal colectomy and adjuvant chemotherapy, followed by recurrence with ovarian involvement consistent with a Krukenberg tumor and subsequent immunotherapy-induced remission. Physical examination and histopathologic findings were consistent with the diagnosis of an SMJN of colorectal origin, supported by immunohistochemical staining confirming metastatic adenocarcinoma of the colon. This case highlights the diagnostic value of a dermatologic evaluation and a timely biopsy in identifying SMJN and guiding appropriate staging and management.