A young gastric carcinoma patient with umbilical and scrotal metastasis.

A 21-year-old gastric carcinoma patients who showed umbilical and scrotal metastasis is reported. Cutaneous metastases are seen in 3-4% of malignant tumors. The most frequent primary sites are the breast, lung, stomach, ovary, colon, uterus and kidney. Intraabdominal malignancies may produce umbilical metastasis. The primary cancer is usually in the stomach, colon, pancreas or ovary. Umbilical metastasis from the stomach seen in our case is known as Sister Joseph's nodule which is a sign of a poor prognosis. Metastatic scrotal carcinoma is a relatively rare condition which occurs by the hematogeneous pathway. However, in our case, direct invasion of tumor cells though the peritoneal cavity and along the lymphatic system of the spermatic cord was the most likely cause of scrotal metastasis.