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What is Sister Mary Joseph suggests? and explain in detail?
Sister Mary Joseph's nodule (SMJN) refers to a metastatic lesion of the umbilicus originating from intra-abdominal or pelvic malignant diseases. The most common primary sites of the metastasis are stomach, ovaries, colon, rectum and pancreas.Proposed mechanisms for the spread of cancer cells to the umbilicus include direct transperitoneal spread; the lymphatics which run alongside the obliterated umbilical vein( ligamentum teres); hematogenous spread; or remnant structures such as the falciform ligament , median umbilical ligament , or a remnant of the vitelline duct . Sister Mary Joseph nodule is associated with multiple peritoneal metastases and has a poor prognosis.Reference : page 986 Bailey and Love's sho practice of surgery 25th edition