Amer Hashim Al Ani, Ehab Totah and Hashim Amer Al Ani
Introduction: Sister Mary Joseph sign, refers to an umbilical nodule in individuals who invariably had a poor outcome and succumbed relatively early, due to metastasis of a malignant cancer in the pelvis, or abdomen.
Presentation of case: We report here a 39 year old male presented with abdominal distension, night sweating, anorexia, and weight Loss. On examination a hard nodule in the umbilical region (Sister Mary Joseph sign) was discovered. CTscan showed omentum cake; ascites and umbilical nodule .colonoscopy showed upper rectal tumor .diagnostic laparoscopy and biopsy confirm metastatic adenocarcinoma disseminated intraperitonealy. Despite the chemotherapy, he died after two months.
Discussion: Sister Joseph sign is usually represents an advanced disease, and carries a very poor prognosis. Because the nodule is so easy to biopsy and because most associated cancers are inoperable at the time of diagnosis, the ability to identify this lesion may save a patient an unnecessary diagnostic surgery.
Conclusion: Clinical examination, (in the presence of high technology investigation), is still of high value in the diagnosis.