Ota Shuji, Haruyama Terunobu, Ishihara Masashi, Natsume Maika, Fukasawa Yoko, Sakamoto Takahiko, Tanzawa Shigeru, Usui Ryo, Honda Takeshi, Ichikawa Yasuko, Watanabe Kiyotaka, Sasajima Yuko, Seki Nobuhiko
aDivision of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
bDivision of Pathology, Teikyo University School of Medicine, Tokyo, Japan.
Case Rep Oncol. 2018 Jan 4;11(1):11-16. doi: 10.1159/000484976. eCollection 2018 Jan-Apr.
The patient was a 66-year-old woman. An induration of approximately 15 mm in size that accompanied redness was palpable in the umbilical fossa. She did not respond to 1-month antibiotic treatment provided by the previous physician. For this reason, a biopsy of the site was performed with the possibility of neoplastic disease in mind, resulting in the detection of adenocarcinoma. Subsequent detailed whole-body examination revealed advanced gastric cancer and peritoneal dissemination, and the induration in the umbilical fossa was diagnosed as a direct infiltration from the peritoneal dissemination. Metastasis or infiltration of malignant tumor to the umbilicus is called Sister Mary Joseph's nodule (SMJN), and considered as a sign of poor prognosis. However, this case was successfully treated and achieved a long-term prognosis by the early diagnosis of SMJN. In routine clinical practice, it is considered necessary to examine patients carefully, as not to overlook SMJN.
患者为一名66岁女性。在脐窝处可触及一个大小约15毫米、伴有红肿的硬结。她对前一位医生提供的为期1个月的抗生素治疗无反应。因此，考虑到可能存在肿瘤性疾病，对该部位进行了活检，结果发现了腺癌。随后的详细全身检查显示为进展期胃癌并伴有腹膜播散，脐窝处的硬结被诊断为腹膜播散的直接浸润。恶性肿瘤转移或浸润至脐部被称为玛丽·约瑟夫修女结节（SMJN），并被视为预后不良的标志。然而，该病例通过对SMJN的早期诊断得到了成功治疗并获得了长期预后。在常规临床实践中，认为有必要仔细检查患者，以免漏诊SMJN。
