Umbilical metastasis: a case series of four Sister Joseph nodules from four different visceral malignancies.

Sister Joseph nodule is a metastatic umbilical lesion secondary to a primary malignancy of any viscera. It can be a presenting symptom (a sign of undiagnosed malignancy) or a symptom or sign of progression or recurrence in a known case. Its incidence is 1%-3% of all intra-abdominal or pelvic malignancies. Here, we present 4 such cases, with Sister Joseph nodule as a finding ofpresentation in a case of gallbladder carcinoma,progression in a case of malignant gastrointestinal stromal tumour,recurrence in a case of ovarian carcinoma, andpresentation in a case of rectal carcinoma.The clinicopathologic features of all 4 patients are discussed, and the related literature is briefly reviewed.