Limmathurotsakul D, Rerknimitr P, Korkij W, Noppakun N, Kullavanijaya P, Rerknimitr R
Metastatic mucinous cystic adenocarcinoma of the pancreas presenting as Sister Mary Joseph's nodule. [Journal Article]
JOP 2007; 8(3):344-9.
CONTEXT: Sister Mary Joseph's nodule usually represents metastatic cancers from gastrointestinal malignancy including adenocarcinoma of the pancreas. Mucinous cystadenocarcinoma is a rare malignancy of the pancreas. However, pancreatic mucinous cystadenocarcinoma metastasized to Sister Mary Joseph's nodule is much rarer and has never been reported before.
CASE REPORT: A 73-year-old Thai woman presented with progressive epigastric discomfort, severe back pain and significant weight loss over a 3 month period. Physical examination revealed right supraclavicular lymphadenopathy and Sister Mary Joseph's nodule at the umbilicus. A CT scan showed a large cystic lesion with internal septation at the pancreatic tail. Cyst fluid analysis revealed a brown mucoid fluid having high carcinoembryonic antigen and carbohydrate antigen 19-9 levels. Skin biopsy from the nodule confirmed the presence of metastatic mucinous cystadenocarcinoma.
CONCLUSION: To our knowledge, this is the first report of pancreatic mucinous cystadenocarcinoma metastasized as Sister Mary Joseph's nodule.
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