Vicente Giner Galvan, MD
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Galvan VG. Sister Mary Joseph's Nodule. Ann Intern Med. 1998;128:410. doi: 10.7326/0003-4819-128-5-199803010-00017
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Published: Ann Intern Med. 1998;128(5):410.
TO THE EDITOR:
Sister Mary Joseph's nodule has traditionally been considered a sign of ominous prognosis (survival of 10 months on average) and suggests therapeutic abstention . We conducted a MEDLINE search of papers published from 1966 to January 1997 to evaluate the evidence for this belief.
It seems necessary to obtain a histopathologic diagnosis because most umbilical tumors are primary . Fine-needle aspiration biopsy has been established as an adequate method for early and easy diagnosis . A total of 407 reports of Sister Mary Joseph's nodules have been published. The most common origins are gastrointestinal (52%), gynecologic (28%), stomach (23%), and ovarian (16%) cancer. Fifteen percent of cases have unknown origins, and 3% originate from the thoracic cavity (Table 1). Most such metastases develop from adenocarcinomas . In 14% to 33% of cases, umbilical metastasis leads to the diagnosis of previously occult neoplasms . In 40% of patients with a known neoplasm, the nodule was an early sign of relapse .
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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