What is a Sister Mary Joseph nodule?
Sister Mary Joseph was the first surgical assistant to Dr. W. J. Mayo, who eventually became the superintendent of St. Mary’s Hospital in Rochester, Minnesota.
A Sister Mary Joseph nodule is an umbilical metastasis of an internal malignancy. In the largest series reported, the most common primary malignancies were stomach (20%), large bowel (14%), ovary (14%), and pancreas (11%). In 20% of cases, the primary could not be established. In 14% of cases, a Sister Mary Joseph nodule was the initial presentation of the internal malignancy.
Umbilical metastases usually indicate advanced disease; the average survival is 10 months. Although it was Dr. Mayo who described the clinical features of nodular umbilical metastases, Sister Mary Joseph is credited with being the first to appreciate that patients with this finding had a poor prognosis.