Al-Mashat F, Sibiany A M
Department of Surgery, King Abdulaziz University Hospital, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Indian J Cancer. 2010 Jan-Mar;47(1):65-9. doi: 10.4103/0019-509X.58862.
The aim of this analysis was to evaluate our management and outcome of eight cases of Sister Mary Joseph's Nodule of the umbilicus (SMJN).
Between 2002 and 2009, we collected eight cases of SMJN and their clinical data were studied in a retrospective manner.
The mean age of the patients was 50.6 years (range, 34-58). There were three males and five females. Five cases were discovered preoperatively during an abdominal examination and in the remaining three patients, the umbilical nodule was noticed during surgery. Most patients presented with abdominal pain. Various signs were discovered during clinical examination. Exhaustive investigations done included ultrasound, computed tomography, magnetic resonance imaging, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, gastrointestinal endoscopy, mammogram, bone scan, and a panel of tumor markers. The primary tumors were gastric adenocarcinoma (two patients), ovarian adenocarcinoma (two patients), pancreatic carcinoma (one patient), colonic adenocarcinoma (one patient), gallbladder adenocarcinoma (one patient), and cholangiocarcinoma (one patient). As the disease was advanced and metastatic in all patients, only palliative therapy was offered. All patients died within a short period after clinical presentation, ranging from four to 58 weeks (mean, 20 weeks).
SMJN is a rare manifestation of a variety of advanced malignancies, usually of gastrointestinal origin. A majority of the patients present at a late stage and many harbor distant metastases. The patient's survival is very short (mean, 20 weeks) leading to a poor outcome. We believe that if the primary cancer is discovered at an early stage, the prognosis may improve.
本分析旨在评估我们对8例脐部玛丽・约瑟夫修女结节（SMJN）的管理及治疗结果。
2002年至2009年期间，我们收集了8例SMJN病例，并对其临床资料进行回顾性研究。
患者的平均年龄为50.6岁（范围34 - 58岁）。男性3例，女性5例。5例在术前腹部检查时被发现，其余3例患者在手术中发现脐部结节。大多数患者表现为腹痛。临床检查发现了各种体征。进行的详尽检查包括超声、计算机断层扫描、磁共振成像、内镜逆行胰胆管造影、磁共振胰胆管造影、胃肠内镜检查、乳房X线摄影、骨扫描以及一组肿瘤标志物检测。原发肿瘤为胃腺癌（2例患者）、卵巢腺癌（2例患者）、胰腺癌（1例患者）、结肠腺癌（1例患者）、胆囊腺癌（1例患者）和胆管癌（1例患者）。由于所有患者疾病均已进展并发生转移，仅提供了姑息治疗。所有患者在临床表现后短时间内死亡，时间范围为4至58周（平均20周）。
SMJN是多种晚期恶性肿瘤的罕见表现，通常起源于胃肠道。大多数患者就诊时已处于晚期，许多患者伴有远处转移。患者生存期很短（平均20周），导致预后不良。我们认为，如果原发性癌症在早期被发现，预后可能会改善。
