Pancreatic cancer revealed by a Sister Mary Joseph´s nodule
Naoual El Omri, Fadwa Mekouar
Corresponding author: Naoual El Omri, Internal Medicine B, Mohammed V Military Teaching Hospital, Sidi Mohamed Ben Abdellah University, Fes, Morocco 
Received: 24 Mar 2020 - Accepted: 08 Jun 2020 - Published: 22 Jun 2020
Domain: Dermatology,Gastroenterology,Internal medicine
Keywords: Umbilical nodule, Sister Mary Joseph´s nodule, pancreatic cancer
©Naoual El Omri et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Naoual El Omri et al. Pancreatic cancer revealed by a Sister Mary Joseph´s nodule. Pan African Medical Journal. 2020;36:113. [doi: 10.11604/pamj.2020.36.113.22486]
Available online at: https://www.panafrican-med-journal.com/content/article/36/113/full
Images in clinical medicine 
Pancreatic cancer revealed by a Sister Mary Joseph´s nodule
Pancreatic cancer revealed by a Sister Mary Joseph´s nodule
Naoual El Omri1,&, Fadwa Mekouar1
&Corresponding author
Sister Mary Joseph´s nodule is a metastatic of a primary cancer, usually adenocarcinoma and associated with poor prognosis. Here we report the case of a 48-year-old man, admitted to the hospital with six months history of epigastric pain without vomiting or externalized hemorrhage and without transit disorders in a context of alteration of the general state with weight loss. Clinical examination showed epigastric sensitivity with a painful umbilical nodule, firm and irregular (A). Laboratory tests revealed a cholestasis. His computed tomography (CT) of the abdomen showed a mass lesion at the tail of the pancreas measuring 45 mm enclosing the splenic artery with secondary ganglionic, hepatic, bone and peritoneal localization (B, C). The umbilical lesion biopsies revealed metastasis of the pancreatic adenocarcinoma (D). The patient received palliative chemotherapy.
Figure 1: (A) sister Mary Joseph´s umbilical nodule; (B) the cross-sectional CT image of the umbilicus showing the umbilical nodule (arrow); (C) mass lesion at tail of the pancreas enclosing the splenic artery (small arrow) with secondary hepatic localization (big arrow); (D) picture HEx100: moderately differentiated adenocarcinoma with a mucosal colloid component whose immunohistochemical profile is consistent with a bilio-pancreatic origin
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