Power of observation: Sister Mary Joseph nodule

An 83-year-old woman was admitted with recent-onset abdominal pain and anorexia. Her vital signs were normal, the abdomen was soft and non-tender with notable umbilical mass and no other significant findings. Laboratory tests and X-rays were unremarkable. Ultrasound-guided core biopsies of the umbilical mass demonstrated high-grade carcinoma (figure 1). Abdominal CT and gynaecological evaluation revealed its source—gynaecological cancer (figure 2). The patient opted for palliative care and passed …