A 44-yo woman had progressive abdominal distension x 1 yr that she believed to be a pregnancy. She did not seek care due to lack of insurance. A growth protruding through the umbilicus oozed serosanguinous fluid. What is it?
Hydatidiform mole (molar pregnancy)
Umbilical herniation
Ascites from abdominal pregnancy
Omphalith (umbilical concretion)
Malignancy (Sister Mary Joseph sign)
You are correct. Debulking surgery revealed a poorly differentiated malignancy involving ovaries and omentum; she succumbed to sepsis post-operatively. Sister Mary Joseph (1856–1939) made the link between intra-abdominal malignancy and umbilical lesions while prepping the skin of patients pre-operatively.