A surgeon examining a cachecttic patient with disseminated gastric adenocarcinoma notices a firm, non-tender nodule at the umbilicus within the remnant of the embryological attachment of the gut. What is this sign called?
- A Sister Mary Joseph nodule ✓
- B Virchow nodule
- C Irish node
- D Krukenberg tumour
Correct answer: A. Sister Mary Joseph nodule
Explanation
A periumbilical metastasis is the Sister Mary Joseph nodule, named after a surgical assistant who noted its association with intra-abdominal malignancy, classically gastric carcinoma. It reflects transcoelomic spread along the falciform ligament and obliterated umbilical veins. The Virchow node is left supraclavicular spread via the thoracic duct, the Irish node is left axillary, and a Krukenberg tumour is ovarian metastasis, usually bilateral and mucin-secreting with signet ring cells.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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