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A Case of Colorectal Cancer Presenting with a Sister Mary Joseph Nodule

A metastatic tumor of the umbilicus is called “Sister Mary Joseph Nodule”, and patients with this tumor show a poor prognosis. Sister Mary Joseph nodule is a rare occurrence, and there are few case reports. We report a case of colorectal cancer in which the patient first presented with the metastatic tumor in the umbilicus. A male patient visited a neighborhood clinic because of a bleeding umbilical tumor, which he had first noticed about three months earlier. At first, the umbilical tumor was diagnosed as omphalitis, and the patient was referred to our hospital. We performed biopsy of the umbilical tumor, and the findings revealed an adenocarcinoma. Abdominal CT showed wall thickening in the descending colon. Therefore, we performed lower gastrointestinal endoscopy, which revealed a colorectal tumor in the descending colon. We performed biopsy of the tumor and the findings were consistent with adenocarcinoma. Based on these results, we diagnosed the umbilical tumor as a metastasis from the colorectal cancer. We performed umbilical resection and colectomy, and the postop-erative course was uneventful. After the operation, the patient received chemotherapy. This case serves to emphasize that in a patient presenting with an umbilical tumor, we must consider the possi-bility of Sister Mary Joseph Nodule, and perform a detailed examination to detect malignancy.