Skin tumours: Sister Mary Joseph nodule: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Skin tumours: Sister Mary Joseph nodule

Sample item

A 62-year-old man with weight loss and abdominal distension has a firm, hard nodule in the umbilicus. Biopsy shows adenocarcinoma. What is the significance of this finding?

APrimary basal cell carcinoma of the umbilicusBAn endometriosis depositCA benign umbilical granulomaDCutaneous metastasis from an intra-abdominal or pelvic malignancy

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Cutaneous metastasis from an intra-abdominal or pelvic malignancy

A Sister Mary Joseph nodule is a metastasis to the umbilicus, most often from gastric, ovarian, colorectal or pancreatic carcinoma, and indicates advanced disease with poor prognosis. It forms by spread through lymphatics, vessels or the peritoneum.

Option by option

A. Primary basal cell carcinoma of the umbilicus
Primary basal cell carcinoma has basaloid cells and is not an adenocarcinoma.
B. An endometriosis deposit
Endometriosis occurs in women and shows endometrial glands and stroma, not carcinoma.
C. A benign umbilical granuloma
A granuloma does not show malignant cells on biopsy.
D. Cutaneous metastasis from an intra-abdominal or pelvic malignancy (correct)
Correct. An umbilical nodule with adenocarcinoma is a metastasis from an abdominal or pelvic primary.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, Cutaneous metastasis from an intra-abdominal or pelvic malignancy. A Sister Mary Joseph nodule is a metastasis to the umbilicus, most often from gastric, ovarian, colorectal or pancreatic carcinoma, and indicates advanced disease with poor prognosis.

Why is "Primary basal cell carcinoma of the umbilicus" not the answer?

Primary basal cell carcinoma has basaloid cells and is not an adenocarcinoma.

Why is "An endometriosis deposit" not the answer?

Endometriosis occurs in women and shows endometrial glands and stroma, not carcinoma.

Why is "A benign umbilical granuloma" not the answer?

A granuloma does not show malignant cells on biopsy.

What concept does this question test?

It tests Skin tumours: Sister Mary Joseph nodule in Dermatology. It forms by spread through lymphatics, vessels or the peritoneum.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Skin tumours: Sister Mary Joseph nodule?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.