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CC BY 4.0 · Surg J (N Y) 2022; 08(02): e127-e130
DOI: 10.1055/s-0042-1749423
Case Report

Umbilical Nodule Metastasis from Unknown Primary: Diagnostic and Therapeutic Dilemma

Sweety Gupta 
1   Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
,
Gaurav Sharma
1   Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
,
Nidhi Sharma
1   Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
,
Shreyosi Mandal
1   Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
,
Amit Gupta
2   Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
,
Manoj Gupta
1   Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Abstract

Umbilical nodule metastasis is not a common presentation of carcinoma of unknown primary. It may be the presenting symptom of a primary malignancy or as metastatic site of previously diagnosed cancer and is considered to be a poor prognostic finding. We here report a case of young male who presented with umbilical mass, but the primary could not be localized even after thorough investigations and work up. Also, there existed therapeutic dilemma because immunohistochemistry did not favor one site, and so he was considered for combination chemotherapy in view of unresectable disease.

Keywords

umbilical - metastases - palliative chemotherapy - unknown primary

Informed Consent

Informed consent was obtained from the participant.




Publication History

Received: 26 July 2021

Accepted: 09 March 2022

Article published online:
30 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Hemminki K, Bevier M, Hemminki A, Sundquist J. Survival in cancer of unknown primary site: population-based analysis by site and histology. Ann Oncol 2012; 23 (07) 1854-1863
    CrossrefPubMedGoogle Scholar
  • 2 Massard C, Loriot Y, Fizazi K. Carcinomas of an unknown primary origin–diagnosis and treatment. Nat Rev Clin Oncol 2011; 8 (12) 701-710
    CrossrefPubMedGoogle Scholar
  • 3 Steck WD, Helwig EB. Tumors of the umbilicus. Cancer 1965; 18: 907-915
    CrossrefPubMedGoogle Scholar
  • 4 Trebing D, Göring HD. The umbilical metastasis. Sister Mary Joseph and her time [in German]. Hautarzt 2004; 55 (02) 186-189
    PubMedGoogle Scholar
  • 5 Dhruv S, Anwar S, Polavarapu A, Kashi M, Andrawes S. Sister Mary Joseph's nodule: where umbilicus holds the truth!. Cureus 2021; 13 (02) e13091
    PubMedGoogle Scholar
  • 6 Galvañ VG. Sister Mary Joseph's nodule. Ann Intern Med 1998; 128 (05) 410
    CrossrefPubMedGoogle Scholar
  • 7 Gabriele R, Borghese M, Conte M, Basso L. Sister Mary Joseph's nodule as a first sign of cancer of the cecum: report of a case. Dis Colon Rectum 2004; 47 (01) 115-117
    CrossrefPubMedGoogle Scholar
  • 8 Abbruzzese JL, Abbruzzese MC, Hess KR, Raber MN, Lenzi R, Frost P. Unknown primary carcinoma: natural history and prognostic factors in 657 consecutive patients. J Clin Oncol 1994; 12 (06) 1272-1280
    CrossrefPubMedGoogle Scholar
  • 9 Losa F, Iglesias L, Pané M. et al. 2018 consensus statement by the Spanish Society of Pathology and the Spanish Society of Medical Oncology on the diagnosis and treatment of cancer of unknown primary. Clin Transl Oncol 2018; 20 (11) 1361-1372
    CrossrefPubMedGoogle Scholar
  • 10 Hemminki K, Pavlidis N, Tsilidis KK, Sundquist K, Ji J. Age-dependent metastatic spread and survival: cancer of unknown primary as a model. Sci Rep 2016; 6: 23725
    CrossrefPubMedGoogle Scholar
  • 11 Oien KA. Pathologic evaluation of unknown primary cancer. Semin Oncol 2009; 36 (01) 8-37
    CrossrefPubMedGoogle Scholar
  • 12 Dar H, Kamili MA, Dar SH, Kuchhai FA. Sister Mary Joseph nodule: an unusual case report with review of literature. Int J Dermatol 2009; 7 (02) 12
    PubMedGoogle Scholar
  • 13 Khan AJ, Cook B. Metastatic carcinoma of umbilicus: “Sister Mary Joseph's nodule”. Cutis 1997; 60 (06) 297-298
    PubMedGoogle Scholar
  • 14 Serhrouchni KI, El Fatemi H, Chbani L, Harmouch T, Amarti A. Umbilical metastasis: A report case and review of the literature. Pathol Discov 2013; 1: 3
    CrossrefPubMedGoogle Scholar
  • 15 Barrow MV. Metastatic tumors of the umbilicus. J Chronic Dis 1966; 19 (10) 1113-1117
    CrossrefPubMedGoogle Scholar
  • 16 Gabriele R, Conte M, Egidi F, Borghese M. Umbilical metastases: current viewpoint. World J Surg Oncol 2005; 3 (01) 13
    CrossrefPubMedGoogle Scholar
  • 17 Cestaro G, De Monti M, Alkayyali S, Fasolini F, Salmoiraghi F. Umbilical metastasis mimicking symptomatic hernia: report of a case of Sister Mary Joseph Syndrome. Int J Surg Case Rep 2017; 41: 105-106
    CrossrefPubMedGoogle Scholar
  • 18 Chen P, Middlebrook MR, Goldman SM, Sandler CM. Sister Mary Joseph nodule from metastatic renal cell carcinoma. J Comput Assist Tomogr 1998; 22 (05) 756-757
    CrossrefPubMedGoogle Scholar
  • 19 Panaro F, Andorno E, Di Domenico S. et al. Sister Joseph's nodule in a liver transplant recipient: case report and mini-review of literature. World J Surg Oncol 2005; 3 (01) 4
    CrossrefPubMedGoogle Scholar
  • 20 Pentheroudakis G, Pavlidis N. Serous papillary peritoneal carcinoma: unknown primary tumour, ovarian cancer counterpart or a distinct entity? A systematic review. Crit Rev Oncol Hematol 2010; 75 (01) 27-42
    CrossrefPubMedGoogle Scholar
  • 21 Pentheroudakis G, Spector Y, Krikelis D. et al. Global microRNA profiling in favorable prognosis subgroups of cancer of unknown primary (CUP) demonstrates no significant expression differences with metastases of matched known primary tumors. Clin Exp Metastasis 2013; 30 (04) 431-439
    CrossrefPubMedGoogle Scholar