Umbilical metastasis mimicking symptomatic hernia: Report of a case of Sister Mary Joseph Syndrome

•Underline the possibility that a complicated umbilical hernia can be a metastasis.•All complicated umbilical hernia in THE adult population should represent a suspicion of advanced metastatic neoplasm.•An umbilical biopsy and abdomen CT SCAN should be mandatory in all case of complicated umbilical hernia in THE adult population. An umbilical mass can be the first symptom of an intra-abdominal neoplasia, and this condition is also defined as Sister Mary Joseph Syndrome. An eighty-year-old patient presented with a complicated umbilical hernia. CT scan abdomen revealed a pancreatic neoplasm and an umbilical biopsy confirmed diagnosis of metastasis. Patient started chemotherapy by Oncologists. In this paper the Authors suggest a histopathological evaluation of umbilical fat in all cases of newly emerging umbilical hernia in the adult population.