RESUMO
Abstract: We report a case of a 76-year-old patient with a history of recent weight loss and ulcerated umbilical nodular lesion. Initially, we considered the diagnostic hypothesis of Sister Mary Joseph's nodule. However, histopathological evaluation revealed that it was an ulcerated intradermal nevus. We perform a brief review of umbilical nodules.
Assuntos
Humanos , Masculino , Idoso , Neoplasias Cutâneas/diagnóstico , Nevo Intradérmico/diagnóstico , Nódulo da Irmã Maria José/diagnóstico , Neoplasias Cutâneas/patologia , Nevo Intradérmico/patologia , Diagnóstico DiferencialRESUMO
El término nódulo de la hermana María José se refiere a la presencia de una lesión umbilical, generalmente de larga evolución,que representa una metástasis cutánea relacionada habitualmente con una neoplasia intra abdominal. Las metástasis umbilicales se presentan por lo general tardíamente en el curso de neoplasias, coincidentes o secundarias a carcinomatosis peritoneal. Su presencia es índice de mal pronóstico ya que se relaciona con una baja sobrevida. Habitualmente, al momento del diagnóstico, los recursos terapéuticos son escasos. A continuación se presenta el caso de una paciente de sexo femenino, intervenida 4 años previos a la consulta por carcinoma de endometrio, que presenta una tumoración abdominal compatible con el diagnostico de Nódulo de la Hermana María José, resultando ser una metástasis cutánea de su neoplasia previa.
The term Sister Mary Joseph ́s nodule is related to the presence of a long development umbilical lesion, usually representing a cutaneous metastasis from an intraabdominal neoplasia. Umbilical metastases often are present lately in the course of neoplasias, coincident or secondary to peritoneal carcinomatosis, and are a poor prognosis indicator associated with low survival. Treatment resources are scarce at the time of diagnosis. We report a female patient, intervened four years ago because an endometrial carcinoma, with an abdominal tumor consistent with Sister Mary Joseph ́s nodule, turning out to be a cutaneous metastasis from her previous neoplasia.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Nódulo da Irmã Maria José/diagnóstico , Nódulo da Irmã Maria José/etiologia , Nódulo da Irmã Maria José/história , Nódulo da Irmã Maria José/terapia , Metástase Neoplásica , UmbigoRESUMO
El nódulo de la Hermana María José se refiere a una metástasis de una neoplasia visceral a ombligo más común de origen gastrointestinal. La importancia de esta lesión es que es de fácil aproximación por el examen físico y su alta asociación con neoplasias malignas intra abdominales y la sencillez para hacer el diagnóstico con métodos como la biopsia aspiración con aguja fina.
Sister Mary Joseph's nodule refers to the metastasis of visceral malignancy to the umbilicus, most commonly of gastrointestinal origin. The noteworthy characteristics of this lesion are its more approachable diagnosis on physical examination, its high association with intra-abdominal malignancy, and its faculty to provide a diagnosis with easily performed methods such as fine needle aspiration biopsy.
O nódulo da irmã Maria José se refere como uma metástase de uma neoplasia visceral a umbigo mais comum de origem gastrointestinal. A importância desta lesão é que é de fácil aproximação pelo exame físico, e sua alta associação com neoplasias malignas intra abdominais e a facilidade para realizar o diagnostico com métodos fáceis de realizar como a biopsia aspiração com agulha fina.
Assuntos
Humanos , Nódulo da Irmã Maria José , Biópsia por Agulha Fina , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Neoplasias Gastrointestinais , Metástase Neoplásica , NeoplasiasRESUMO
The umbilicus can be affected by various skin diseases including metastasis of internal malignancies, at which point it is known as Sister Mary Joseph's Nodule. The authors report a case of Sister Mary Joseph's Nodule as the first sign of internal malignancy and highlight the importance for the dermatologist to recognize the condition.
A cicatriz umbilical pode ser acometida por diversas dermatoses inclusive metástase de neoplasias internas quando então recebe a denominação de nódulo da Irmã Maria José. Os autores relatam um caso de nódulo da Irmã Maria José como primeiro sinal de neoplasia interna destacando desta forma a importância do dermatologista no reconhecimento desta entidade.
Assuntos
Idoso de 80 Anos ou mais , Feminino , Humanos , Adenocarcinoma/secundário , Neoplasias Ovarianas/patologia , Nódulo da Irmã Maria José/secundário , Neoplasias Cutâneas/secundário , Umbigo/patologiaRESUMO
Umbilical metastases from intraperitoneal malignancies are universally referred to Sister Mary Joseph's nodule (SMJN). The most frequent primary tumor sites include the stomach and ovaries. SMJN caused by colon cancer is uncommon. Likewise, carcinoma of the right side colon metastasizing to inguinal lymph nodes is considered almost impossible. To the best of our knowledge, there is no report of right side colon cancer synchronously involving both the umbilicus and inguinal lymph nodes in the literature. We present a case of right side colon cancer (RSCC) metastasizing to the umbilicus and inguinal lymph nodes, which was confirmed by routine pathological evaluation and immuohistochemistry.
Assuntos
Adulto , Humanos , Masculino , Adenocarcinoma , Patologia , Cirurgia Geral , Antígeno Carcinoembrionário , Sangue , Metabolismo , Colectomia , Métodos , Neoplasias do Colo , Patologia , Cirurgia Geral , Virilha , Queratina-20 , Metabolismo , Excisão de Linfonodo , Linfonodos , Patologia , Cirurgia Geral , Metástase Linfática , Nódulo da Irmã Maria José , Patologia , Cirurgia GeralRESUMO
Umbilical metastasis may be the first presenting sign of the disease, or an indication of a recurrence from a previous malignancy. We recently encountered a 19-year-old woman with advanced ovarian adenocarcinoma whose first sign was having a Sister Mary Joseph's nodule. This patient only presented an umbilical nodule with slight lower abdominal discomfort, without any other subjective symptom. The lesion was fresh red, firm, ulcerating and has 1.5 cm in diameter. A punch biopsy from the lesion revealed metastatic adenocarcinoma and a PET-CT scan showed hypermetabolism on the umbilicus. After a systemic evaluation, she had a laparotomy including right salpingo-oophorectomy, total omentectomy, pelvic and paraaortic lymphadenectomy, appendectomy, and extirpation of the umbilicus. The patient received a postoperative combination of chemotherapy with paclitaxel and carboplatin, and still remains alive. This case demonstrates the importance of careful evaluation of any umbilical lesion and pathologic examination.
Assuntos
Feminino , Humanos , Adulto Jovem , Adenocarcinoma , Apendicectomia , Biópsia , Carboplatina , Laparotomia , Excisão de Linfonodo , Metástase Neoplásica , Paclitaxel , Recidiva , Irmãos , Nódulo da Irmã Maria José , Úlcera , UmbigoRESUMO
Metastatic cancer of the umbilicus is very rare and is called Sister Mary Joseph's nodule. Metastasis to the umbilicus usually presents as diffuse spreading of primary cancer or recurrence after treatment of primary cancer, carries very poor prognosis, and is generally inoperable. However, umbilical metastasis presents rarely as a first sign of primary cancer and can lead to its diagnosis. The diagnosis is usually made with the histologic examination and the most common primary cancer is an adenocarcinoma of the stomach. We report a case of umbilical metastasis as a first sign of gastric cancer which leads to its diagnosis. This report emphasizes the need for careful evaluation of any umbilical lesion.
Assuntos
Humanos , Adenocarcinoma , Metástase Neoplásica , Prognóstico , Recidiva , Irmãos , Nódulo da Irmã Maria José , Estômago , Neoplasias Gástricas , UmbigoRESUMO
A metastatic umbilical carcinoma from internal malignancy is known as Sister Mary Joseph's nodule. A 56-year-old man presented with a progressively enlarging umbilical nodule. Skin biopsy was done and the patient was diagnosed as metastatic adenocarcinoma of umbilicus. Search for the primary tumor revealed gastric adenocarcinoma with metastasis to perigastric lymph node, portal vein and intrahepatic duct. Sister Mary Joseph's nodule, a rare form of cutaneous metastasis, generally carries very poor prognosis. We describe a case of Sister Mary Joseph's nodule preceding a diagnosis of gastric cancer with review of the literature, and emphasize the importance of careful evaluation of any umbilical nodule.