Sister Mary Joseph's nodule as the first presenting sign of advanced fallopian tube carcinoma: A case report.

Abstract

Fallopian tube carcinoma has a rare incidence and dismal prognosis. Sister Mary Joseph's nodule is an intra-abdominal tumor that metastasizes to the umbilicus. To date, fewer than 10 cases of fallopian tube carcinoma with Sister Mary Joseph's nodule have been reported, with most of them exhibiting a very poor prognosis. Herein, we described a case of fallopian tube carcinoma with Sister Mary Joseph's nodule. A 57-year-old woman was referred to the Affiliated Hospital of Shandong Second Medical University in May 2020 owing to a mass in the middle of her umbilicus. She was first diagnosed with an umbilical mass and underwent a resection of the umbilical mass, which revealed adenocarcinoma, most likely of reproductive origin. One month after the first surgery, she underwent laparoscopic cytoreductive surgery, and pathological examination revealed fallopian tube adenocarcinoma with pelvic lymph node metastasis. She was diagnosed with fallopian tube carcinoma (stage IIIC) and then underwent 10 cycles of chemotherapy. She achieved a complete response, and no recurrence or progression has been reported until now. The overall survival time exceeded 50 months. Thus, for patients with umbilical masses, physicians should consider the possibility of Sister Mary Joseph's nodule. When a malignancy is suspected in the abdominal or pelvic cavity but the physical examination and imaging studies reveal no abnormality, laparoscopic surgery should be used for determining the primary tumor. For patients with fallopian tube carcinoma and Sister Mary Joseph's nodule, surgery and adjuvant chemotherapy can achieve good results.