Sister Mary Joseph’s Nodule Revealing Advanced Metastatic Ovarian Neoplasia: A Case Report

Abstract: Sister Mary Joseph’s nodule (SMJN) is an umbilical metastasis originating from an intra-abdominal or pelvic malignancy. Although uncommon, it is a highly suggestive clinical sign of advanced neoplastic disease and is associated with a poor prognosis. We report the case of a 47-year-old woman with no significant medical history who presented to the emergency department with a painful inflammatory peri-umbilical mass. Clinical history revealed a rapid deterioration of general condition with cachexia and progressive bedridden status over the preceding two months. Physical examination showed a violaceous umbilical mass with surrounding inflammatory changes and minimal serous discharge. Contrast-enhanced thoraco-abdomino-pelvic computed tomography demonstrated a pelvic mass suggestive of ovarian malignancy associated with multiple metastatic lesions involving the liver, spleen, lungs, peritoneum, and abdominal wall. Despite supportive management, the patient’s condition rapidly deteriorated, and she died 48 hours after admission.