The cutaneous metastasis of a
visceral malignancy to the umbilicus is known as "Sister
In 1949 the English surgeon Sir
Hamilton Bailey coined this term after
was a superintendent nurse at St.
Mary's Hospital in
It may be the first sign of an
underlying adenocarcinoma, originating mainly from the gastrointestinal or
Most of the primary tumours are
located in the stomach, pancreas, large bowel and the ovary.
It is considered to be a
predictor of poor prognosis because it mostly occurs in advanced, metastasizing
Clinically, the lesion is characterized by an irregular nodule, with ulceration
and bloody discharge.
It may also present as an induration of the subcutaneous tissue
Careful examination of all
umbilical lesions is needed for the early diagnosis of internal malignancy.