# A dark umbilical nodule in a postmenopausal woman: What is your diagnosis?

## TL;DR

A rare umbilical nodule in a postmenopausal woman can signal advanced cancer and requires prompt medical attention.

## Contribution

This case highlights the importance of recognizing Sister Mary Joseph’s nodule as a potential sign of metastatic endometrial carcinoma.

## Key findings

- A 58-year-old woman with a dark umbilical lesion was diagnosed with metastatic endometrial carcinoma.
- Sister Mary Joseph’s nodule can be the first sign of an occult primary cancer in primary care settings.

## Abstract

Sister Mary Joseph’s nodule is a rare but significant clinical sign that often indicates advanced intraabdominal malignancy. It presents as a palpable umbilical nodule and may be the first indication of an occult primary cancer. In this article, we discuss the case of a 58-year-old postmenopausal woman who presented to a primary care clinic with a darkened umbilical lesion and progressive abdominal symptoms. She wps ultimately diagnosed with metastatic endometrial carcinoma. This uncommon presentation highlights the importance of a comprehensive approach to umbilical lesions in the primary care setting. Recognising this subtle sign in primary care can lead to expedited investigations and timely intervention.