Sister Mary Joseph's nodule in advanced ovarian cancer

摘要

Case report A 66-year-old woman was referred to our hospital for the management of recurrent ovarian adenocarcinoma. Eight years earlier, she presented with a mass in the left ovary without ascites, which was treated with optimal debulking surgery and surgical staging. The histological diagnosis was consistent with endometrioid ovarian cystadenocarcinoma of the left ovary; stage IIa (FIGO classification). The patient was treated postoperatively with adjuvant chemotherapy and palliative chemotherapy was administrated after disease relapses.A firm, non-tender, 3.5 cm diameter umbilical nodule, painless with smooth surface and without ulceration or discharge was detected on clinical examination (Figure 1). Fine-needle aspiration of the umbilical nodule was performed and conventional cytological smears as well as thin prep cytology were taken. Cytology showed the presence of malignant cells, which were small sized with scant or little cytoplasm and small round to oval hyperchromatic nuclei with a granular chromatic pattern. A panel of monoclonal antibodies for B72.3 and keratin 7 was performed and immunoreactivity for B72.3 and keratin was detected. The cytological diagnosis based on the patients clinical history and the morphological and immunocy-tochemical findings was consistent with metastatic adenocarcinoma. Additionally, a CT scan of the abdomen was done and a 3.5 cm soft tissue umbilical mass was found, with multiple peritoneal and liver metastases.