Non-umbilical Cutaneous Metastasis of Pancreatic Adenocarcinoma as the First Clinical Manifestation: A Case Report

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.

Alopecia neoplastica as a sign of visceral malignancies: a systematic review

“…Women were more represented with the 53.7% (66/123) of cases, compared to the 46.3% (57/123) of men . Median age of AN at onset was 59 (IQR: 47–68).…”

“…Regarding the primary site of malignancy, gastrointestinal (GI) tract accounted for 24.4% (30/123), breast for 17.9% (22/123) of cases, kidney for 8.1% (10/123), lung for 7.3% (9/123), thyroid for 7.3% (9/123), uterus for 6.5% (8/123), central nervous system (CNS) for 6.5% (8/123), liver for 3.3% (4/123) and other anatomic areas for 18.7% (23/123) of cases …”

“…Regarding the primary site of malignancy, gastrointestinal (GI) tract accounted for 24.4% (30/123), 2,14,16,23,30,32,33,36,46,48,49,56,61,63,64,71,78,79,83,84,88,93,96,98,101,102,105,106,115,118 breast for 17.9% (22/123) of cases, 4,6,7,10,11,13,15,[17][18][19]26,27,29,34,35,37,44,66,67 kidney for 8.1% (10/123), lung for 7.3% (9/ 123), 25,38,43,<...>…”

“…According to gender distribution of primary tumours, we obviously found that the 100% of patients with uterus cancer (8/ 8) 64,65,84 while in 24.8% (30/121) cases, the diagnosis was synchronous. 7,8,18,20,23,31,33,35,44,46,48,56,68,69,72,73,[76][77][78]81,84,87,93,95,96,99,102,110,111 The specific sites of primary tumours in each of these subgroups were reported in Table S1 (Supporting Information). Considering cases diagnosed after the primary tumour, they were mainly derived from breast and GI cancers (18/88 cases each); synchronous cases prevalently had a GI origin (10/30 cases), while cases diagnosed before the primary tumour were only three (one from GI, namely one thyroid and one lung cancer).…”

“…Ulceration (histologically diagnosed) was present in 31 out of 94 cases (33%), 13,15,26,[28][29][30][31]34,38,42,46,52,56,60,68,69,72,[76][77][78]80,84,92,95,97,102,106,109,114,116,117 with a higher incidence in AN related to lung cancer (4/5 cases). 68,69,72,77 The main colour of AN lesions was red-violaceous (66.7% -66/99), 2,4,6,8,9,12,13,15,17,20,21,27-29,34,40,42,43,46,47,50,53,55,57,59,61,63,65,67,68,70,71,73,75,76,78,80,83,85-89,91-93, 95-100,102,104,105,108-110,113,115-118,120,121 followed by flesh-coloured in 25.3% (25/99) 10,11,14,16,19,[23][24][25]32,33,36,45,…”