Nódulo da Irmã Maria José – um sinal semiológico de alerta: relato de caso

Abstract

Introduction: The Sister Mary Joseph Sign was described by Hamilton Bailey in 1949, in honor of Dr. William Mayo's surgical assistant. It is a hardened and fast-growing nodule, fissured or ulcerated and appearing in the umbilical region via lymphatic, hematogenous or contiguous routes. The stomach and colon in men and ovaries in women are the most common primary sites. Objective: To present a case report on the semiological sign of Sister Maria José and its relationship with malignant neoplasms. Case report: A 71-year-old woman, referred by Basic Health Unit (UBS) to look for a general surgeon, diagnosed with “probably imprisoned umbilical hernia”. She had an ulcerated tumor on the umbilical scar. Abdominal tomography showed multiple expansive formations with gross calcifications, with ill-defined limits in the pelvic cavity. Biopsy of the lesion showed adenocarcinoma with a micropapillary pattern eroding the skin. The definitive diagnosis was advanced ovarian cancer, and only clinical cancer treatment was chosen. Conclusion: The sign of Sister Mary Joseph may be the first manifestation of a neoplasm and its recognition is important on the part of the doctor, so that a diagnostic investigation can be initiated and an appropriate treatment can be proposed, even though it characterizes an advanced stage of the neoplasm.