What is the following palpable, non-reducible, and non-painful physical exam finding and what disease does it suggest?
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Sister Mary Joseph nodule; advanced malignancy usually of gastrointestinal or gynecologic origin
The Sister Mary Joseph nodule is a rare finding representing a periumbilical or umbilical metastasis from a malignancy usually of the gastrointestinal tract or ovary.
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Fun fact: Sister Mary Joseph was a nurse and first surgical assistant to Dr. William Mayo of the Mayo Clinic. She was a key player in the success of the Mayo Clinic. During her time preparing patients for surgery, she sometimes noted periumbilical nodules in patients with advanced visceral malignancies and brought this to the attention of Dr. Mayo. This finding was eventually given its eponym in her honor.