Gastric Cancer Diagnosed with Metastasis of the Navel (Sister Mary Joseph's Nodule) - A Case Report
Katayama, T.; Ishii, T.; Tono, T.; Okubo, Y.; Shinozaki, K.; Kawasaki, Y.; Senba, S.; Yasuda, S.; Otsuru, M.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 43(12): 1905-1907
2016
ISSN/ISBN: 0385-0684 PMID: 28133171 Document Number: 687699
A woman in her 60s was admitted to our hospital with pain and induration of the navel. She was diagnosed with gastric cancer with metastasis to the navel and underwent total gastrectomy and navel extraction. Because disseminated nodules were detected in the Douglas pouch and sigmoid colon, sigmoidectomy was performed to prevent bowel obstruction. The navel tumor was histologically diagnosed as a metastasis of the gastric cancer. One month after surgery, a chest skin tumor, which was also a skin metastasis of the gastric cancer[T4aN3M1(SKI, OTH)H0P1, fStage IV ], was detected, and tumor enucleation was performed. Enucleation was followed by 47 courses of systemic chemotherapy consisting of capecitabine, cisplatin, and trastuzumab. No recurrence or metastasis has been observed via FDG-PET/CT as of 5 years after surgery. Gastric cancer with peritoneal dissemination in addition to navel metastasis has been reported to have an extremely poor prognosis. However, long-term, recurrence-free survival was obtained in this case owing to aggressive surgical resection, followed by persistent systemic chemotherapy.