What Is the Sister Mary Joseph Nodule?

A Sister Mary Joseph nodule is a lesion around the navel that indicates the metastatic spread of an abdominal cancer. This is an important clinical sign, as it indicates that a cancer has not only developed, but spread beyond the original site. For patients who have a Sister Mary Joseph nodule, the prognosis can be poor. The tumor may not be removable through surgery, and could resist chemotherapy and radiation because of the size and level of involvement.
This lesion takes the form of one or more hard, painful lumps. They may become moist or crusty. It is named for the Catholic nurse who first noticed it in patients with metastatic abdominal cancers. Originally written up in the 1920s, the Sister Mary Joseph nodule was retroactively named for her in the 1950s to recognize her contribution to the field of medicine.
Abdominal cancers, such as bowel cancer, are the most likely source of a Sister Mary Joseph nodule, but these growths can also develop in cases of uterine and other reproductive cancers. In some cases, the lesions are the first sign that a patient has a problem. Patients may initially dismiss discomfort and irritation, until the growths around the abdomen develop and make it obvious that something is wrong in the abdomen. The doctor can take a sample for biopsy to examine the cells, confirm the growths are malignant, and find out where they originated.
Strange growths around the abdomen are not necessarily malignant. Sometimes fungal infections and other conditions cause lesions to develop. Differential diagnosis is very important to find out what is causing the lesions. If a growth is indeed a Sister Mary Joseph nodule, the patient may need medical imaging studies to look for cancer in other areas of the body. As much information as possible should be collected to find out more about the type and extent of the malignancy.
Patients have some treatment options they can discuss. In some cases, surgery could be available, and may help arrest the spread of the cancer in addition to making the patient more comfortable. Chemotherapy and radiation could also be options. A poor prognosis is not a death sentence, and some patients recover from abdominal cancers, if they receive aggressive and early treatment. An oncologist can provide more information about possible outcomes with different courses of treatment and the best possible options for the patient, given the circumstances.

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