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.
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.