1
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Park SH, Zhassanov Z, Kang CM. Port-site metastasis after laparoscopic radical pancreatosplenectomy in left-sided pancreatic cancer. Ann Hepatobiliary Pancreat Surg 2024; 28:104-108. [PMID: 38178691 PMCID: PMC10896680 DOI: 10.14701/ahbps.23-092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 01/06/2024] Open
Abstract
Despite debates regarding the safety of well-selected left-sided pancreatic cancer, minimally invasive distal pancreatosplenectomy is considered safer and more effective than open distal pancreatosplenectomy in well-selected patients. Previous studies have shown that minimally invasive surgery yields comparable oncologic outcomes to open surgery. While patients who undergo minimally invasive distal pancreatosplenectomy also experience recurrences and metastases after surgery, port-site metastasis is particularly rare. In this report, we report an extremely rare case of port-site metastasis following minimally invasive distal pancreatosplenectomy for left-sided pancreatic cancer.
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Affiliation(s)
- Su Hyeong Park
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - Zhanay Zhassanov
- Division of Multidisciplinary Surgery, Tau Sunkar, Almaty, Kazakhstan
| | - Chang Moo Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
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2
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Cassalia F, Bolzon A, Ponzano M, Ventura L, Danese A, Del Fiore P, Belloni Fortina A, Jovine E, Perri G, Cillo U, Marchegiani G. The Importance of Reading the Skin: Cutaneous Metastases of Pancreatic Cancer, a Systematic Review. J Clin Med 2023; 13:104. [PMID: 38202111 PMCID: PMC10779471 DOI: 10.3390/jcm13010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Pancreatic cancer is notorious for its aggressive nature and low survival rate, with less than 10% of patients surviving beyond five years. Early detection is difficult, but skin metastases can be a rare but significant indicator. This systematic review focuses on the epidemiology, clinical features, and histology of skin metastases from pancreatic cancer to determine their importance in early diagnosis and overall management of the disease. MATERIALS AND METHODS Following PRISMA guidelines, we conducted an exhaustive search of MEDLINE/PubMed, EMBASE, and SCOPUS databases up to June 2023, using specific keywords. Four independent investigators screened the studies using predefined criteria, and two investigators checked the accuracy and consistency of the data extraction. We assessed the quality of the trials using adapted criteria from the Joanna Briggs Institute. A narrative synthesis rather than a meta-analysis was chosen because of the different study designs. RESULTS The final analysis included 57 patients with skin metastases from pancreatic cancer. Cutaneous metastases, although rare, presented with approximately equal gender distribution and a mean age of 63.4 years. Predominantly non-umbilical (77%), these metastases showed clinical diversity, ranging from asymptomatic nodules to painful or ulcerated lesions. Notably, skin metastases often preceded the diagnosis of primary pancreatic cancer (58%). Primary tumor characteristics revealed different localizations, with adenocarcinoma being the most prevalent histological type (77%). A significant association (p = 0.008) was observed between pancreatic tumor location and the timing of presentation of skin metastases. Tumors located in the body and tail of the pancreas were more likely to manifest skin metastases as an initial clinical manifestation (62.2%) than those in the head of the pancreas (20.8%). CONCLUSIONS In conclusion, although skin metastases are rare, they are important indicators of pancreatic cancer, highlighting the need for multidisciplinary healthcare collaboration and thorough skin examination. Recognizing them could lead to earlier diagnosis, which is crucial in a cancer with limited treatment options.
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Affiliation(s)
- Fortunato Cassalia
- Dermatology Unit, Department of Medicine [DIMED], University of Padua, 35121 Padua, Italy; (F.C.); (A.B.); (M.P.); (A.B.F.)
| | - Anna Bolzon
- Dermatology Unit, Department of Medicine [DIMED], University of Padua, 35121 Padua, Italy; (F.C.); (A.B.); (M.P.); (A.B.F.)
| | - Monica Ponzano
- Dermatology Unit, Department of Medicine [DIMED], University of Padua, 35121 Padua, Italy; (F.C.); (A.B.); (M.P.); (A.B.F.)
| | - Laura Ventura
- Department of Statistics, University of Padua, 35121 Padova, Italy;
| | - Andrea Danese
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37129 Verona, Italy;
| | - Paolo Del Fiore
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy;
| | - Anna Belloni Fortina
- Dermatology Unit, Department of Medicine [DIMED], University of Padua, 35121 Padua, Italy; (F.C.); (A.B.); (M.P.); (A.B.F.)
- Department of Woman’s and Children’s Health, University of Padua, 35121 Padua, Italy
| | - Elio Jovine
- Department of General Surgery, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Maggiore Hospital, 40133 Bologna, Italy;
| | - Giampaolo Perri
- Department of General Surgery, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Maggiore Hospital, 40133 Bologna, Italy;
- Hepatopancreatobiliary and Liver Surgery, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, 35121 Padua, Italy; (G.P.); (U.C.)
| | - Umberto Cillo
- Hepatopancreatobiliary and Liver Surgery, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, 35121 Padua, Italy; (G.P.); (U.C.)
| | - Giovanni Marchegiani
- Hepatopancreatobiliary and Liver Surgery, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, 35121 Padua, Italy; (G.P.); (U.C.)
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3
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Fang F, Wang AA, Kapali M, Lai J. Beta-HCG-Positive Pancreatic Duct Adenocarcinoma Initially Presenting with Cutaneous Metastases. J Gastrointest Cancer 2023; 54:1383-1385. [PMID: 37195401 DOI: 10.1007/s12029-023-00942-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 05/18/2023]
Affiliation(s)
- Felix Fang
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Anne A Wang
- Department of Pathology and Laboratory Medicine, Hospital of University of Pennsylvania, Philadelphia, PA, USA
| | - Malathy Kapali
- Department of Pathology and Laboratory Medicine, Kaiser Permanente Sacramento Medical Center, Sacramento, CA, 95825, USA
| | - Jinping Lai
- Department of Pathology and Laboratory Medicine, Kaiser Permanente Sacramento Medical Center, Sacramento, CA, 95825, USA.
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4
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March-Rodriguez A, Pesqué D, Lobato-Berezo A, Pujol RM. Cutaneous metastasis from pancreatic cancer misdiagnosed as neuropathic foot ulcer. Indian J Dermatol Venereol Leprol 2023; 89:883-885. [PMID: 37067127 DOI: 10.25259/ijdvl_561_2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/24/2022] [Indexed: 03/30/2023]
Affiliation(s)
| | - David Pesqué
- Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | | | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
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5
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Veron Sanchez A, Santamaria Guinea N, Cayon Somacarrera S, Bennouna I, Pezzullo M, Bali MA. Rare Solid Pancreatic Lesions on Cross-Sectional Imaging. Diagnostics (Basel) 2023; 13:2719. [PMID: 37627978 PMCID: PMC10453474 DOI: 10.3390/diagnostics13162719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Several solid lesions can be found within the pancreas mainly arising from the exocrine and endocrine pancreatic tissue. Among all pancreatic malignancies, the most common subtype is pancreatic ductal adenocarcinoma (PDAC), to a point that pancreatic cancer and PDAC are used interchangeably. But, in addition to PDAC, and to the other most common and well-known solid lesions, either related to benign conditions, such as pancreatitis, or not so benign, such as pancreatic neuroendocrine neoplasms (pNENs), there are solid pancreatic lesions considered rare due to their low incidence. These lesions may originate from a cell line with a differentiation other than exocrine/endocrine, such as from the nerve sheath as for pancreatic schwannoma or from mesenchymal cells as for solitary fibrous tumour. These rare solid pancreatic lesions may show a behaviour that ranges in a benign to highly aggressive malignant spectrum. This review includes cases of an intrapancreatic accessory spleen, pancreatic tuberculosis, solid serous cystadenoma, solid pseudopapillary tumour, pancreatic schwannoma, purely intraductal neuroendocrine tumour, pancreatic fibrous solitary tumour, acinar cell carcinoma, undifferentiated carcinoma with osteoclastic-like giant cells, adenosquamous carcinoma, colloid carcinoma of the pancreas, primary leiomyosarcoma of the pancreas, primary and secondary pancreatic lymphoma and metastases within the pancreas. Therefore, it is important to determine the correct diagnosis to ensure optimal patient management. Because of their rarity, their existence is less well known and, when depicted, in most cases incidentally, the correct diagnosis remains challenging. However, there are some typical imaging features present on cross-sectional imaging modalities that, taken into account with the clinical and biological context, contribute substantially to achieve the correct diagnosis.
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Affiliation(s)
- Ana Veron Sanchez
- Hôpital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium; (I.B.)
| | | | | | - Ilias Bennouna
- Hôpital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium; (I.B.)
| | - Martina Pezzullo
- Hôpital Universitaire de Bruxelles, Hôpital Erasme, 1070 Brussels, Belgium
| | - Maria Antonietta Bali
- Hôpital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium; (I.B.)
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6
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Gu L, Mehta PP, Rao D, Rotemberg V, Capanu M, Chou J, Lin S, Sigel CS, Busam KJ, Boyce L, Gordon A, O'Reilly EM. Pancreatic cancer: Cutaneous metastases, clinical descriptors and outcomes. Cancer Med 2023; 12:179-188. [PMID: 35666021 PMCID: PMC9844595 DOI: 10.1002/cam4.4916] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/11/2022] [Accepted: 05/17/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Cutaneous metastases in pancreatic cancer (PC) are rare. Herein, we evaluate the clinical, genomic, and other descriptors of patients with PC and cutaneous metastases. METHODS Institutional databases were queried, and clinical history, demographics, PC cutaneous metastasis details, and overall survival (OS) from cutaneous metastasis diagnosis were abstracted. OS was estimated using Kaplan-Meier methods. RESULTS Forty patients were identified, and median age (Q1-Q3, IQR) of PC diagnosis was 66.0 (59.3-72.3, 12.9) years. Most patients had Stage IV disease at diagnosis (n = 26, 65%). The most common location of the primary tumor was the tail of the pancreas (n = 17, 43%). The most common cutaneous metastasis site was the abdomen (n = 31, 78%), with umbilical lesions occurring in 74% (n = 23) of abdominal lesions. The median OS (95% CI) was 11.4 months (7.0, 20.4). Twenty-three patients had umbilical metastases (58%), and 17 patients had non-umbilical metastases (43%). The median OS (95% CI) was 13.7 (7.0, 28.7) months in patients with umbilical metastases and 8.9 (4.1, Not reached) months in patients with non-umbilical metastases (p = 0.1). Sixteen of 40 (40%) patients underwent somatic testing, and findings were consistent with known profiles. Germline testing in 12 (30%) patients identified pathogenic variants in patients: CHEK2, BRCA1, and ATM. CONCLUSION Cutaneous metastases from PC most frequently arise from a pancreas tail primary site and most frequently occur in the umbilicus. Cutaneous metastases may generally be categorized as umbilical or non-umbilical metastases.
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Affiliation(s)
- Lilly Gu
- Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- Weill Cornell MedicineNew YorkNew YorkUSA
| | - Paras P. Mehta
- Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Devika Rao
- Gastrointestinal Oncology Service, Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Veronica Rotemberg
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Marinela Capanu
- Department of Epidemiology & BiostatisticsMemorial Sloan KetteringNew YorkNew YorkUSA
| | - Joanne Chou
- Department of Epidemiology & BiostatisticsMemorial Sloan KetteringNew YorkNew YorkUSA
| | - Sabrina Lin
- Department of Epidemiology & BiostatisticsMemorial Sloan KetteringNew YorkNew YorkUSA
| | - Carlie S. Sigel
- Department of PathologyMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Klaus J. Busam
- Department of PathologyMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Lindsay Boyce
- Memorial Sloan Kettering LibraryMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Allison Gordon
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Eileen M. O'Reilly
- Weill Cornell MedicineNew YorkNew YorkUSA
- Gastrointestinal Oncology Service, Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- David M. Rubenstein Center for Pancreatic Cancer, MSKNew YorkNew YorkUSA
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7
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Abdelaziz M, Thorley D, Ahmed W. Cutaneous presentation of metastatic pancreatic cancer. J Surg Case Rep 2022; 2022:rjac589. [PMID: 36589687 PMCID: PMC9797327 DOI: 10.1093/jscr/rjac589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/26/2022] [Indexed: 12/29/2022] Open
Abstract
Pancreatic cancer typically presents with a cholestatic picture of jaundice, bloating and bowel changes, secondary to the obstruction of the biliary system. In tail of pancreas metastases, this clinical presentation may be absent, meaning that the disease progression can be more insidious. Cutaneous spread in pancreatic malignancies is often iatrogenic due to direct spread from the tumour site during diagnostic sampling or surgery. Rarely, cutaneous spread can be noted at distant sites, which is associated with widespread disease dissemination and poor prognostic outcomes. Our case focusses on a patient who developed metastatic spread to the chin, as a first presentation, with no other significant associated symptoms identified.
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Affiliation(s)
- Mohammed Abdelaziz
- Correspondence address. ENT Department, Tameside General Hospital, Ashton-Under-Lyne, OL6 9RW, UK. Tel. 0161 922 6468; E-mail:
| | - Daniel Thorley
- ENT Department, Tameside General Hospital, Ashton Under Lyne, UK
| | - Waseem Ahmed
- ENT Department, Tameside General Hospital, Ashton Under Lyne, UK
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8
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Kunovsky L, Dite P, Brezinova E, Sedlakova L, Trna J, Jabandziev P. Skin manifestations of pancreatic diseases. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2022; 166:353-358. [PMID: 35938387 DOI: 10.5507/bp.2022.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/08/2022] [Indexed: 12/15/2022] Open
Abstract
Although symptoms of pancreatic diseases such as pancreatitis, acute and chronic and, carcinoma of the pancreas are mainly gastrointestinal in nature, the extra-pancreatic symptoms are also important. These include skin symptoms, such as pancreatic panniculitis, acanthosis nigricans, livedo reticularis, necrolytic migratory erythema, cutaneous signs of hemorrhage, as in persons with severe acute pancreatitis, or the finding of cutaneous metastases of pancreatic carcinoma, which may be a sign of advanced disease. The pancreas is therefore one of those organs for which diagnosis and therapy are often multidisciplinary. In this review article, we summarize current knowledge of the possible skin manifestations of pancreatic disorders.
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Affiliation(s)
- Lumir Kunovsky
- Department of Surgery, University Hospital Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic.,2nd Department of Internal Medicine - Gastroenterology and Geriatrics, University Hospital Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.,Department of Gastroenterology and Digestive Endoscopy, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Petr Dite
- Department of Gastroenterology and Internal Medicine, University Hospital Brno, Czech Republic.,Faculty of Medicine, University of Ostrava, Czech Republic
| | - Eva Brezinova
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,1st Department of Dermatovenerology, St. Anne's University Hospital, Brno, Czech Republic
| | - Libuse Sedlakova
- Department of Dermatology, Military Hospital Brno, Czech Republic
| | - Jan Trna
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Gastroenterology and Digestive Endoscopy, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Petr Jabandziev
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Pediatrics, University Hospital Brno, Czech Republic.,Central European Institute of Technology, Masaryk University, Brno, Czech Republic
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9
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Aghighi M, Bagher Shokravi M, Rahvar M. Metastatic Pancreatic Adenocarcinoma to Umbilical Skin. Cureus 2022; 14:e24568. [PMID: 35651431 PMCID: PMC9138325 DOI: 10.7759/cureus.24568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/20/2022] Open
Abstract
Sister Mary Joseph nodule (SMJN) is a rare metastasis to umbilical skin originating from internal tumors including the stomach, ovary and large intestine and less commonly from pancreatic cancers. We report an uncommon case of metastatic pancreatic adenocarcinoma to umbilical skin. An 85-year-old female presented with a 1.8 cm protrusion of the right lateral umbilicus. The CT scan showed a 3.5 cm pancreatic lesion, peritoneal carcinomatosis and abdominal lymphadenopathy. Histology examination revealed atypical infiltrative glandular structures. Immunohistochemistry showed positive CK7, negative CDX2 and P53 with mutated patterns. These were consistent with metastatic adenocarcinoma most consistent with pancreatobiliary or upper GI origin. CK7 expresses in the ductal cells in pancreatic ductal adenocarcinoma. While CDX2 is positive in intestinal-type adenocarcinoma, it is negative in pancreatic ductal adenocarcinoma. The diagnosis of adenocarcinoma is rendered based on the presence of a pancreatic lesion in CT scan, positive CK7 and negative CDX2 in umbilical nodule tumor cells in the current patient.
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10
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Odisho T, Joseph S, Shahait A, Choi-Kim L, McGee J, Kim S. OUP accepted manuscript. J Surg Case Rep 2022; 2022:rjac138. [PMID: 35495083 PMCID: PMC9048657 DOI: 10.1093/jscr/rjac138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
Pancreatic cancer has a low survival rate even after ostensible complete resection, and treatment for recurrence is usually only palliative. However, rare solitary metastasis can occur and may be operable. In this report, we describe such a case and review the literature on metastasectomy for pancreatic adenocarcinoma. A 66-year-old female underwent Whipple procedure at our institution in 2014 for a pT3N0 pancreatic adenocarcinoma. A slowly growing umbilical mass was noted 6 years later with concomitant rise in her CA 19-9 levels. CT-guided biopsy of her abdominal wall mass confirmed a well-differentiated adenocarcinoma consistent with her primary pancreatic cancer. The patient underwent metastasectomy of the isolated abdominal wall mass, with negative margins. She received no further postoperative treatment. The patient remains disease and symptom-free over 18 months after resection of the metastasis. In highly selected cases of pancreatic adenocarcinoma, resection of solitary metastasis may be therapeutic.
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Affiliation(s)
- Tanya Odisho
- Correspondence address. Department of Surgery, Detroit Medical Center, Sinai Grace Hospital, 6071 Outer Dr. W, Detroit, MI 48235, USA. E-mail:
| | - Stephanie Joseph
- Department of Surgery, Detroit Medical Center, Detroit, MI, USA
- The Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Awni Shahait
- Department of Surgery, Detroit Medical Center, Detroit, MI, USA
- The Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lydia Choi-Kim
- The Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Oncology, Karmanos Cancer Institute, Detroit, MI, USA
| | - Jessica McGee
- The Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Steve Kim
- The Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Oncology, Karmanos Cancer Institute, Detroit, MI, USA
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11
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Dharan M, Ryan-Fisher C. Sister Mary Joseph Nodule and Concomitant Pancreatitis as Initial Presentation of Pancreatic Adenocarcinoma - Case Report and Review of the Literature. Cureus 2021; 13:e20069. [PMID: 35003942 PMCID: PMC8723718 DOI: 10.7759/cureus.20069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 11/28/2022] Open
Abstract
Umbilical metastasis [Sister Mary Joseph Nodule (SMJN)] is a rare presentation of visceral abdominal/pelvic malignancy. It is less commonly seen in metastatic pancreatic adenocarcinoma and there are only over a hundred cases to date in the literature on this topic. This article highlights a case of metastatic pancreatic adenocarcinoma presenting as SMJN and concomitant pancreatitis (which to the best of our knowledge is the first such report to date) with discussions regarding the etiopathogenesis of this phenomenon and presents a brief literature review on pancreatic adenocarcinoma presenting as SMJN.
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Affiliation(s)
- Murali Dharan
- Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, USA
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12
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Bardhi R, Adlam T, St Claire K, Utz Petry S, Moossavi M. Dermatomal eruption as the first clinical manifestation of recurrent metastatic pancreatic cancer. JAAD Case Rep 2021; 18:37-39. [PMID: 34805470 PMCID: PMC8590034 DOI: 10.1016/j.jdcr.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Redina Bardhi
- School of Medicine, Wayne State University, Detroit, Michigan
| | - Taylor Adlam
- Department of Dermatology, Wayne State University, Detroit, Michigan
| | - Kayla St Claire
- Department of Dermatology, Wayne State University, Detroit, Michigan
| | - Sarah Utz Petry
- Department of Dermatology, Wayne State University, Detroit, Michigan
| | - Meena Moossavi
- Department of Dermatology, Wayne State University, Detroit, Michigan
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13
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Nasser S, Husseini A, Pasula S, Sandhu A. Cutaneous metastatic pancreatic adenocarcinoma. BMJ Case Rep 2021; 14:e245657. [PMID: 34728510 PMCID: PMC8565567 DOI: 10.1136/bcr-2021-245657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sarah Nasser
- Internal Medicine and Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Abraham Husseini
- Internal Medicine and Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Shirisha Pasula
- Infectious Disease, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Avnish Sandhu
- Infectious Disease, Wayne State University School of Medicine, Detroit, Michigan, USA
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14
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Assaf I, Mans L, Sakr R, Verset G, Van Laethem JL. Unusual metastasis in BRCA mutated pancreatic cancer while on maintenance Olaparib: Two case reports and review of the literature. Eur J Cancer 2021; 157:63-67. [PMID: 34487986 DOI: 10.1016/j.ejca.2021.07.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/14/2021] [Accepted: 07/29/2021] [Indexed: 12/12/2022]
Abstract
The most common metastatic sites of pancreatic cancer are the liver, lymph nodes, peritoneum and lung. Here we report two cases of BRCA mutated pancreatic cancer that developed unusual metastasis while treatment with maintenance Olaparib and leading to rapid death. We hereby review the literature and address the possibility of a different nature and tumour biology of BRCA mutated cancer treated with PARP inhibitors.
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Affiliation(s)
- Irene Assaf
- Departement of Medical Oncolgy, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
| | - Laura Mans
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Rita Sakr
- Departement of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Gontran Verset
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean L Van Laethem
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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15
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Casasola-Sánchez LE, Burdio-Pinilla F, Pereira-Rodríguez JA, Radosevic A, Visa L, Sánchez-Velázquez P. Abdominal Wall Metastasis of Pancreatic Cancer: The Tip of the Iceberg-Case Report. Pancreas 2021; 50:e31-e32. [PMID: 33835982 DOI: 10.1097/mpa.0000000000001761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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16
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Shi Y, Li SS, Liu DY, Yu Y. Cutaneous metastases of pancreatic carcinoma to the labia majora: A case report and review of literature. World J Gastrointest Oncol 2020; 12:1372-1380. [PMID: 33250968 PMCID: PMC7667456 DOI: 10.4251/wjgo.v12.i11.1372] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/29/2020] [Accepted: 10/19/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cutaneous metastases originating from pancreatic cancer are relatively rare. The most common reported site of metastasis is the umbilicus, and this manifestation is known as the Sister Mary Joseph’s nodule. Non-umbilical cutaneous metastases are far less common, with only a few cases reported in the literature. Our case is the first case report, to our knowledge, on metastasis involving the labia majora and flat papules.
CASE SUMMARY A 49-year-old Chinese female patient presented with a number of red, swollen papules on the vulva for 2 mo. Histological examination of the labia majora lesion revealed metastatic adenocarcinoma. The serum levels of tumor biomarkers CA199, CA242, and CA125 were significantly elevated. B-mode ultrasound-guided needle biopsy of the pancreas demonstrated moderately and poorly differentiated adenocarcinoma. The patient finally declined treatment for financial reasons and died 3 mo later.
CONCLUSION Metastatic cutaneous lesions could indicate pancreatic cancer. Serum levels of tumor biomarkers may aid in diagnosing metastatic pancreatic adenocarcinoma.
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Affiliation(s)
- Ying Shi
- Department of Dermatology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Shan-Shan Li
- Department of Dermatology and Venereology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Dan-Yan Liu
- Department of Radiology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Yan Yu
- Department of Dermatology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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17
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Chatterjee S. Metastatic Pancreatic Adenocarcinoma Primarily Presenting with Multiple Cutaneous Nodules—a Rare Entity. Indian J Surg 2020. [DOI: 10.1007/s12262-020-02122-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Miulescu R, Balaban DV, Sandru F, Jinga M. Cutaneous Manifestations in Pancreatic Diseases-A Review. J Clin Med 2020; 9:E2611. [PMID: 32806580 PMCID: PMC7464368 DOI: 10.3390/jcm9082611] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 02/07/2023] Open
Abstract
Pancreatic pathology, comprising acute and chronic pancreatitis, autoimmune pancreatitis and pancreatic neoplasms, primarily presents with gastrointestinal symptoms and signs; however, it is well recognized that it can also associate a wide range of extra-digestive features. Among these systemic manifestations, cutaneous involvement plays an important role both as a diagnostic clue for the pancreatic disease itself and serving as a prognostic factor for the severity of the condition. Recognition of these cutaneous signs is, however, far from being satisfactory, all the more as some of them are relatively rare. In the current review, we discuss skin involvement in pancreatic diseases, referring to pancreatic panniculitis, cutaneous hemorrhagic manifestations, skin metastasis, acanthosis nigricans, livedo reticularis, necrolytic migratory erythema and cutaneous fistula. We highlight the clinical characteristics, treatment and prognostic value of these lesions. Better awareness among medical specialties other than dermatology is needed for detection of the skin clues associated with pancreatic pathology.
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Affiliation(s)
- Raluca Miulescu
- Dermatology Department, Elias University Emergency Hospital, 011461 Bucharest, Romania; (R.M.); (F.S.)
| | - Daniel Vasile Balaban
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, Romania;
- Gastroenterology Department, “Dr. Carol Davila” Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Florica Sandru
- Dermatology Department, Elias University Emergency Hospital, 011461 Bucharest, Romania; (R.M.); (F.S.)
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, Romania;
| | - Mariana Jinga
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, Romania;
- Gastroenterology Department, “Dr. Carol Davila” Central Military Emergency University Hospital, 010825 Bucharest, Romania
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19
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Schneiderman H, Lopetegui-Lia N, Nichols J. The Enduring and Practical Power of Physical Examination: Carnett Sign. Am J Med 2020; 133:682-684. [PMID: 31677935 DOI: 10.1016/j.amjmed.2019.09.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Henry Schneiderman
- Section Chief of Geriatrics and Palliative Care, Trinity Health Of New England-Saint Francis Hospital and Medical Center, Hartford, Conn; Professor of Medicine, University of Connecticut School of Medicine, Farmington, Conn; Professor of Medicine, Quinnipiac University School of Medicine, North Haven, Conn; Clinical Professor, Nursing, Yale University, New Haven, Conn.
| | - Nerea Lopetegui-Lia
- Department of Internal Medicine, University of Connecticut School of Medicine, Farmington, Conn
| | - Julianne Nichols
- Department of Cardiology, Great Lakes Cardiovascular, Buffalo, NY
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20
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Salari B, Sheinbein DM, Rosman IS, Dehner LP. Metastatic pancreatic adenosquamous carcinoma to the scalp: A case report and review of the literature. J Cutan Pathol 2020; 47:263-268. [PMID: 31587324 DOI: 10.1111/cup.13582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 12/30/2022]
Abstract
Metastatic carcinoma to the skin occurs in only a minority of patients with a visceral or internal malignancy, with breast, lung, and colorectum accounting for the majority of cases. We present the case of a 66-year-old man with a recent violaceous nodule of the left scalp (1.2 × 1.0 × 0.2 cm) that was a metastatic pancreatic adenosquamous carcinoma, representing a seemingly rare event. Two months prior, after complaining of right hip pain, an image revealed a right femoral lesion. A biopsy of that lesion showed moderately differentiated adenocarcinoma. Subsequent imaging showed a mass in the pancreatic tail and also markedly elevated serum tumor markers, CA 19-9 and carcinoembryonic antigen (5325 and 111.5 U/mL, respectively). Before the appearance of the scalp nodule, the patient received radiotherapy and was started on chemotherapy, which was continued after diagnosis and resection of the nodule. Subsequent metastases developed in the liver, lung and additional cutaneous lesions. He died 11 months after initial presentation with right hip pain. As this case shows, cutaneous metastases confer a poor prognosis, often with less than a year survival following their appearance.
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Affiliation(s)
- Behzad Salari
- Lauren V. Ackerman Laboratory of Surgical Pathology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
| | - David M Sheinbein
- Division of Dermatology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
| | - Ilana S Rosman
- Lauren V. Ackerman Laboratory of Surgical Pathology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
- Division of Dermatology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
| | - Louis P Dehner
- Lauren V. Ackerman Laboratory of Surgical Pathology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
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21
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Abstract
Recognizing the skin manifestations of metabolic and endocrine disorders, many of which may have potentially lethal complications, is important for dermatologists and other clinicians. The skin can be a window into a patient's internal health, and cutaneous manifestations can facilitate early diagnosis and intervention of potentially life-altering systemic disorders with associated morbidity and mortality. This contribution provides an overview of the diverse rashes associated with potentially lethal, acquired metabolic and endocrine disorders of the pituitary, thyroid, parathyroid, pancreas, adrenals, and blood, as well as neuroendocrine and nutritional disease.
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Affiliation(s)
- Fatima N Mirza
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jonathan S Leventhal
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA.
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22
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Goel A, Gaur MK, Sharma S, Garg PK. Skin Lumps and Leg Humps: an Unusual Presentation of a Common Visceral Malignancy. J Gastrointest Cancer 2018; 49:504-506. [PMID: 28293904 DOI: 10.1007/s12029-017-9932-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Aakanksha Goel
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Dilshad Garden, Delhi, 110095, India
| | - Manish Kumar Gaur
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Dilshad Garden, Delhi, 110095, India
| | - Sonal Sharma
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Dilshad Garden, Delhi, 110095, India
| | - Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Dilshad Garden, Delhi, 110095, India.
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23
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Moon JI, Park JY, Jeon TJ, Choi JM, Shin WC, Sung JM, Kim YM, Kim HJ. Non-umbilical Cutaneous Metastasis of Pancreatic Adenocarcinoma as the First Clinical Manifestation: A Case Report. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2017; 68:221-224. [PMID: 27780948 DOI: 10.4166/kjg.2016.68.4.221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Non-umbilical cutaneous metastases from pancreatic adenocarcinomas are extremely rare. Only a few cases have been reported in the literature. An 83-year-old Korean woman, with no previous medical history, presented with a painful nodule on her scalp. Histologic examination of the nodule revealed a metastatic adenocarcinoma, and immunohistochemical staining was positive for cytokeratin (CK) 7 and CK 19. These findings were consistent with a metastatic carcinoma of pancreatic origin. An abdominal computed tomography scan identified a mass on the pancreatic head and multiple enlarged lymph nodes. Pathological examination of an endoscopic ultrasound-guided fine needle biopsy of the pancreatic mass determined that it was a poorly differentiated carcinoma. The patient refused any treatment owing to her old age and short life expectancy. Four months later, the disease progressed rapidly, and the patient died.
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Affiliation(s)
- Ji In Moon
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Ji Young Park
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Tae Joo Jeon
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jung Min Choi
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Won Chang Shin
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - June Min Sung
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Young Moon Kim
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Hyun Jung Kim
- Department of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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24
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Cutaneous Metastasis of a Mucoepidermoid Carcinoma of the Pancreas: First Reported Case. Am J Dermatopathol 2017; 38:852-856. [PMID: 27043340 DOI: 10.1097/dad.0000000000000604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Mucoepidermoid pancreatic cancer is a rare entity with only 8 cases reported in the literature. On review of the literature, the authors found that cutaneous metastases in pancreatic cancer are rare and have not been associated with the mucoepidermoid subtype. The authors present the first reported case of cutaneous metastasis in a patient with mucoepidermoid carcinoma of the pancreas. CASE PRESENTATION A 50-year old white male with a metastatic invasive poorly differentiated mucoepidermoid carcinoma of the pancreas was found to have a slow growing lesion in the skin over his left upper quadrant while undergoing active therapy. The lesion was biopsied and the pathology was consistent with pancreatic origin sharing similar morphologic features when compared with the primary pancreactectomy specimen. CONCLUSIONS Mucoepidermoid pancreatic cancer is an exceedingly rare subtype of pancreatic cancer, with very little information regarding its diagnosis, treatment, and patterns of metastases. Here, the authors present the first reported case of cutaneous metastases of mucoepidermoid pancreatic cancer.
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25
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Kotsantis I, Economopoulou P, Dritsakos K, Oikonomopoulos N, Bakogeorgos M, Rapti C, Kentepozidis N. Extensive cutaneous metastases of pancreatic adenocarcinoma: a case report and review of the literature. Clin Case Rep 2017; 5:51-56. [PMID: 28096990 PMCID: PMC5224779 DOI: 10.1002/ccr3.737] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 07/23/2016] [Accepted: 10/10/2016] [Indexed: 12/30/2022] Open
Abstract
Herein, we present the case of a patient with pancreatic cancer and nonumbilical cutaneous metastasis. Patients with pancreatic adenocarcinomas can develop extensive cutaneous metastases involving not only abdominal skin but also other unusual sites such as the scrotum.
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Affiliation(s)
- Ioannis Kotsantis
- 2 Department of Internal MedicineSection of Medical OncologyAttikon University HospitalSchool of MedicineNational Kapodistrian University of AthensAthensGreece
| | - Panagiota Economopoulou
- 2 Department of Internal MedicineSection of Medical OncologyAttikon University HospitalSchool of MedicineNational Kapodistrian University of AthensAthensGreece
| | | | | | | | - Cleopatra Rapti
- Department of Medical Oncology251 Airforce General HospitalAthensGreece
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27
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Tavío-Hernández E, Cañete-Ruiz Á, Moreno C, Urech M, Cano-Ruiz A. Multiple scalp metastases as a first manifestation of pancreatic adenocarcinoma. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2015. [DOI: 10.1016/j.rgmxen.2015.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Tavío-Hernández E, Cañete-Ruiz Á, Moreno C, Urech M, Cano-Ruiz A. Multiple scalp metastases as a first manifestation of pancreatic adenocarcinoma. REVISTA DE GASTROENTEROLOGIA DE MEXICO 2015; 80:287-9. [PMID: 26070373 DOI: 10.1016/j.rgmx.2015.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/14/2015] [Accepted: 04/29/2015] [Indexed: 11/19/2022]
Affiliation(s)
- E Tavío-Hernández
- Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid, España.
| | - Á Cañete-Ruiz
- Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid, España
| | - C Moreno
- Servicio de Anatomía Patológica, Hospital Ramón y Cajal, Madrid, España
| | - M Urech
- Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, España
| | - A Cano-Ruiz
- Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid, España
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29
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Shin WY, Lee KY, Ahn SI, Park SY, Park KM. Cutaneous metastasis as an initial presentation of a non-functioning pancreatic neuroendocrine tumor. World J Gastroenterol 2015; 21:9822-9826. [PMID: 26361431 PMCID: PMC4562968 DOI: 10.3748/wjg.v21.i33.9822] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 05/26/2015] [Accepted: 07/08/2015] [Indexed: 02/06/2023] Open
Abstract
Non-functioning pancreatic neuroendocrine tumors (NF-PNETs) are rare tumors that account for 2% of all pancreatic malignancy. About 60% of NF-PNETs present distant metastases and usually hepatic metastases. However, cutaneous metastases are very rare. Herein, we report our experience with a 60-year-old male who visited our outpatient clinic with a mass on his left hip. An abdominal computerized tomography scan demonstrated not only a left hip mass and an enlarged left inguinal lymph node, but also a huge heterogeneous enhancing mass on the pancreas. Initially, we removed the metastatic lesions, which was a small cell neuroendocrine carcinoma with 50% of the Ki-67 index in the histopathological report. After 3 wk, we performed a total pancreatectomy and a total gastrectomy. Four weeks after the 1st operation, we detected a recurrence at the operative bed on his left hip, and subsequently removed the recurring mass. The patient was receiving chemotherapy based on etoposide and cisplatin treatment.
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