LAUSR

A 66yearold diabetic woman was admitted for an abdominal nodule that had been evolving for 6 months. Clinical examination found an isolated umbilical nodule of 3.5 cm without any other symptoms or signs (figure 1A). Abdominal CT showed a left hypodense hepatic nodule. Liver function tests were normal. The plasma level of CA199 was elevated at 13150 IU/ mL. Abdominal MRI revealed a left intrahepatic mass measuring 49×58 mm (figure 2). The pathological study of the umbilical nodule and hepatic biopsies was suggestive of cholangiocarcinoma CK7+ and CK19+ (figure 3). The final diagnosis was Sister Mary Joseph’s nodule, revealing cholangiocarcinoma. The patient underwent six cycles of Gemcis chemotherapy. The improvement was characterised by the decrease of the nodule’s size with partial