The term Sister Mary Joseph (SMJ) nodule refers to a rare metastatic malignant neoplasm of the periumbilical region. The eponym, which first appeared in Sir Hamilton Bailey's book on physical signs, honors Dr William Mayo's first assistant, Sister Mary Joseph, who observed that patients with advanced abdominal cancer often had umbilical nodules. Metastatic tumors of the umbilicus are usually adenocarcinomas of gastrointestinal origin.1