Case Report  |   July 2020
Sister Mary Joseph Nodule in a Patient With Advanced Prostate Cancer
Author Notes
  • From the Division of Internal Medicine in the Department of Medicine at the University of Florida College of Medicine in Jacksonville. 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Michael Chahin, DO, University of Florida College of Medicine, 653 W 8th St #L18, Jacksonville, FL 32209-6511. Email: michael.chahin@jax.ufl.edu
     
Article Information
Urological Disorders
Case Report   |   July 2020
Sister Mary Joseph Nodule in a Patient With Advanced Prostate Cancer
The Journal of the American Osteopathic Association, July 2020, Vol. 120, 476-478. doi:https://doi.org/10.7556/jaoa.2020.075
The Journal of the American Osteopathic Association, July 2020, Vol. 120, 476-478. doi:https://doi.org/10.7556/jaoa.2020.075
Abstract

Prostate cancer is the second most common cause of cancer death among US men. Metastasis typically occurs in the bone, lymph nodes, liver, and thorax. This case highlights a patient who was suspected of having prostate cancer several years before presenting to the emergency department with back pain and an umbilical hernia of increasing size. Gross examination revealed fixed masses on the abdominal wall that appeared malignant on computed tomographic imaging. The umbilical mass was a Sister Mary Joseph nodule (SMJN), which is sometimes found in patients with advanced, metastatic abdominal cancer. An SMJN is most commonly suggestive of gastrointestinal or gynecologic cancer, but it is a rarely reported finding in the context of prostate cancer. SMJN is a frequently missed finding that may delay further investigation for malignant neoplasms. This case reinforces the importance of this physical examination finding and provides evidence for adding prostate cancer to the list of possible diagnoses for patients who have an SMJN.

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