Sister Mary Joseph Nodule on Abdominal Examination

A 75-year-old man with no past medical history presented with a 6-month history of right costovertebral pain. Additionally, he noted a weight loss of 30 lb. Physical examination showed a thin male and the abdominal examination was notable for the finding seen in Figure A. Laboratory evaluation revealed normocytic anemia with hemoglobin of 9.2 (normal range, 11.5–14.8 g/dL), which is decreased from patient's baseline hemoglobin of 12 g/dL. Iron studies showed anemia of chronic disease. A computed tomography abdomen/pelvis displayed