Sister Mary Joseph nodule as the only sign of silent caecal adenocarcinoma

Abstract Sister Mary Joseph nodule is a nodule localized in the umbilicus which represents a cutaneous metastasis from a primary cancer, mostly localized in the abdomen. We report the case of an 82-year-old woman who presented with an ulcerated umbilical nodule. Imaging identified it as a Sister Mary Joseph nodule, representing the only distant metastasis from a silent caecal adenocarcinoma. When an umbilical nodule is found at clinical examination imaging can play a crucial role in determining underlying pathology and in determining therapeutic strategy.