This article is an answer to the Case – Painful Umbilical Nodule
In the 2 days before presentation, the patient noted new bloody exudate from the nodule. Physical examination revealed a painful and firm, erythematous umbilical nodule measuring 2 cm in its largest diameter and a palpable pelvic mass.
Computed tomography of the abdomen and pelvis showed a heterogeneous pelvic mass measuring 11 cm by 11 cm by 9.5 cm (arrow), moderate ascites, peritoneal carcinomatosis, and a nodule measuring 2.4 cm (largest diameter) in the umbilical region (arrowhead).
![CT Abdomen showing pelvic mass, moderate ascites, peritoneal carcinomatosis, and a nodule in the umbilical region](https://manualofmedicine.com/wp-content/uploads/2023/05/CT-Abdomen-showing-pelvic-mass-moderate-ascites-peritoneal-carcinomatosis-and-a-nodule-in-the-umbilical-region.jpg)
Diagnostic laparoscopy and biopsies of the large mass, umbilical nodule, and peritoneal implants were performed, and pathological analysis confirmed the diagnosis of high-grade serous ovarian carcinoma.
A Sister Mary Joseph’s nodule is a metastatic umbilical lesion in the umbilicus and is typically associated with gynecologic and gastrointestinal cancers. The patient underwent cytoreductive surgery and received adjuvant chemotherapy.