In medicine, the<unk>  or more commonly node, also called<unk> <unk><unk>  sign, refers to a palpable nodule bulging into the umbilicus as a result of metastasis of a malignant cancer in the pelvis or abdomen.<unk> s can be painful to palpation. A periumbilical mass is not always a<unk> . Other conditions that can cause a palpable periumbilical mass include umbilical hernia, infection, and endometriosis. Medical imaging, such as abdominal ultrasound, may be used to distinguish a<unk>  from another kind of mass. Gastrointestinal malignancies account for about half of underlying sources (most commonly gastric cancer, colonic cancer or pancreatic cancer, mostly of the tail and body of the pancreas), and men are even more likely to have an underlying cancer of the gastrointestinal tract. Gynecological cancers account for about 1 in 4 cases (primarily ovarian cancer and also uterine cancer). Nodules will also, rarely, originate from appendix cancer spillage and pseudomyxoma peritonei. Unknown primary tumors and rarely, urinary or respiratory tract malignancies can cause umbilical metastases. How exactly the metastases reach the umbilicus remains largely unknown. Proposed mechanisms for the spread of cancer cells to the umbilicus include direct transperitoneal spread, via the lymphatics which run alongside the obliterated umbilical vein, hematogenous spread, or via remnant structures such as the falciform ligament, median umbilical ligament, or a remnant of the vitelline duct.<unk>  is associated with multiple peritoneal metastases and a poor prognosis.
Sister Mary Joseph nodule
Rokitansky nodule
Gandy–Gamna nodules
Cold nodule
Milker's nodule
Koeppe's nodules
Lobular carcinoma in situ
Colloid nodule