Sister Marie Joseph nodule and Krükenberg's tumor: rare association revealing a gastric adenocarcinoma

It was about a 61-year-old patient who presented an indurated and painless umbilical swelling surrounded by ulcerated plaque and an abdominal arch progressing for 8 months. Abdomino-pelvic ultrasound and abdominal-pelvic CT scan revealed in right ovarian the presence of a mass with a cystic's tissue, a thickness with a subcutaneous infiltration of the umbilical region and the diffuse infiltration of gastric parietal mesenteric fat. Histology of the ovarian mass confirmed Krükenberg's tumor and that of the Sister Marie-Joseph's nodule confirmed umbilical skin metastasis. The primary was a well differentiated gastric adenocarcinoma. The death occurred after the first chemotherapy treatment. The association of Krükenberg's tumor with Sister Marie-Joseph's nodule, rare and unusual, has been revealing of a gastric adenocarcinoma which up to now was unknown and asymptomatic.