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Review
of Clinical Signs

Sister Joseph’s Nodule

Series Editor and Author: Frank L. Urbano, MD

1. Which of the following statements regarding the distinctive features of Sister Joseph’s nodule is NOT true?
  1. It is typically less than 5 cm in diameter
  2. It is usually firm and indurated
  3. It is usually painful
  4. It may have a bloody discharge
  5. The skin over the nodule may become ulcerated
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2. Which of the following types of cancer has NOT been shown to cause Sister Joseph’s nodule?

  1. Acute myelogenous leukemia
  2. Cervical carcinoma
  3. Colorectal carcinoma
  4. Hepatocellular carcinoma
  5. Malignant melanoma
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  3. Which of the following is NOT a postulated mode by which metastatic cancer may spread to the umbilical region?
  1. Contiguous extension of a peritoneal carcinoma
  2. Direct extension along the ligaments of embryonic origin
  3. Hematogenous spread via a persistent vitelline artery
  4. Lymphatic spread through any one of 4 sets of lymphatics
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4. Which of the following statements regarding the clinical course of Sister Joseph’s nodule is NOT true?

  1. It generally indicates a poor prognosis
  2. It is commonly treated with surgery and adjunctive therapy
  3. It may ulcerate and exude a discharge
  4. It most commonly indicates advanced, metastasizing cancer
  5. Some patients may have a Sister Joseph’s nodule but no other signs or symptoms of an internal malignancy
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