What is it about?
A 70-year-old woman with type 2 diabetes developed worsening blood sugar control and later an umbilical lump (Sister Mary Joseph’s nodule). Imaging and biopsy revealed pancreatic cancer that had spread to the navel.
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Why is it important?
Diabetes increases the risk of pancreatic cancer and can mask symptoms (e.g., less abdominal pain due to neuropathy). A rapid rise in HbA1c may be an early warning sign of hidden cancer. Sister Mary Joseph’s nodule, although rare, is a key clinical clue that may signal advanced malignancy.
Perspectives
In older diabetic patients with worsening glucose control, clinicians should always consider underlying cancer. Careful physical exam of the umbilicus can reveal important diagnostic findings. Early recognition may enable timelier imaging and treatment, even though prognosis in such cases is usually poor.
Prof Takuya Omura
National Center for Geriatrics and Gerontology
Read the Original
This page is a summary of: Pancreatic cancer manifesting as Sister Mary Joseph nodule during follow up of a patient with type 2 diabetes mellitus: A case report, Geriatrics and Gerontology International, April 2019, Wiley,
DOI: 10.1111/ggi.13602.
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