Subcutaneous metastasis at a surgical drain site after the resection of pancreatic cancer (original) (raw)
Related papers
Cutaneous Metastasis at a Surgical Drain Site after Gastric Cancer Resection
Case Reports in Oncology, 2010
Cutaneous metastasis from intra-abdominal malignant solid tumours such as gastric adenocarcinoma is very rare. Here, we report the case of a 76-year-old male patient with a T4N2M0, poorly differentiated, signet-ring cell gastric carcinoma, who underwent potentially curative resection of the tumour and developed cutaneous metastasis at the site of the surgical drain 4 months after the operation while he was on chemotherapy. The lesion involved the skin and the subcutaneous fat only. A CT scan revealed local recurrence at the resection bed but no distant metastases. The patient died 1 month later. It is concluded that the development of cutaneous metastasis after gastric carcinoma resection indicates tumour recurrence or disseminated disease and is associated with poor prognosis.
Pancreatic cancer account for less than 5% of human malignant neoplasms but represents the fourth leading cause of cancer death. Currently, there is no early diagnostic test or effective treatment for this disease once it is locally advanced. Cutaneous metastases from pancreatic cancer are relatively rare. The most common site of cutaneous metastasis is the umbilicus, and this is known as Sister Mary Joseph's nodule. A site other than umbilicus is rare. Very few patients have been reported with non-umbilical metastasis and only a handful with scalp lesion. This is a case report of a patient who presented with a scalp lesion as the first clinical manifestation of a pancreatic carcinoma and a brief review of reported non-umbilical cutaneous metastases in the literature.
Pancreatic Resections for Metastatic Disease
Advances in Pancreatic Cancer, 2018
Although the incidence of metastases to the pancreas from various primaries is very low, these lesions are usually being described as part of the systemic recurrence of different malignancies, in certain cases isolated pancreatic metastases might be encountered. When it comes to the malignancies, which might lead to the apparition of pancreatic metastases, the most common origins have been reported to be renal cell carcinoma, colon cancer, ovarian cancer and melanomas. In certain cases, patients with pancreatic metastases might be submitted to surgery with curative intent. However, it should not be omitted that pancreatic resections can be associated with higher rates of perioperative morbidity; therefore, a precise selection of the cases that are considered suitable for such procedures is mandatory. It seems that the best results in regard with long-term survival are expected in cases with isolated pancreatic metastases as well as in cases with limited extrapancreatic lesions, amenable to complete cytoreductive surgery. This chapter reviews the most important studies conducted on the theme of pancreatic resections for metastatic disease from various primaries.
Complications of Pancreatic Cancer Resection
Digestive Surgery, 2002
Pancreatic cancer is a common cause of cancer death in the developed world. Currently, resection is the only chance of long-term survival. The post-operative mortality in nonspecialist centres often exceeds 20% but is around 6% or less in specialist centres. The overall complication rate even in specialist centres is 18-54%. An analysis of eleven large series of pancreatic resections shows an incidence of common complications of 10.4% for fistula, 9.9% for delayed gastric emptying, 4.8% for bleeding, 4.8% for wound infection and 3.8% for intraabdominal abscess. The median hospital stay is 13-18 days in different series. The re-operation rate varies from 4 to 9% with a mortality rate of 23 to 67%. Major complications are a significant factor in post-operative mortality, especially if they require re-operation. The use of octreotide or somatostatin to prevent complications is supported by several multicentre, double-blind, randomized controlled trials. The best way to improve outcome is to concentrate pancreatic cancer care in regional specialist centres.
Pancreatic resection for metastatic melanoma
HPB: Official Journal of The International Hepato Pancreato Biliary Association, 2003
The pancreas is an occasional site of metastases from melanoma. It may be the only location of metastatic disease, but more often the melanoma metastasises to other organs as well. Treatment options are somewhat limited, and the role of operative treatment is poorly de®ned.
General Aspects of Surgical Treatment of Pancreatic Cancer
Digestive Surgery, 1999
Background: Different results and opinions exist concerning the use of a standard or an extended lymphadenectomy, and about the indications for portal vein resection in the surgical treatment of pancreatic cancer. The site of recurrence of pancreatic cancer may help to define the usefulness of different treatments in avoiding local and/or distant recurrences. Methods: From personal experience and a literature review, 841 patients who underwent portal vein resection were collected, and 29 papers reporting the results of extended lymphadenectomy in the surgical treatment of pancreatic cancer were analyzed. A review of the site of relapse according to the surgical treatment, with or without various adjuvant treatments, was performed. Personal experience on survival rate according to the site of relapse (local, distant, local and distant) is also reported. Results: Portal vein resection has been performed without a significant increase in morbidity and mortality rate in a large number of patients. However, its usefulness for increasing the resectability rate and the long-term survival has yet to be established. Extended lymphadenectomy does not increase the morbidity and mortality rate, but conflicting results on long-term survival have been reported. Distant metastases, undetectable by the radiologist and the surgeon, usually kill more than 40% of the resected patients within 12 months. Only lymph node-positive patients with limited undetectable distant metastases seem to benefit from an extended lymphadenectomy. Although many data are lacking, the incidence of the different sites of relapse is the same whatever the surgical and/or adjuvant treatment performed. Overall survival and disease-free survival rate are not affected by the site of relapse. A significantly worse survival rate was observed after the radiological detection of local and distant metastasis than after an only local or only distant metastasis. Conclusion: Portal vein resection and extended lymphadenectomy can be performed without increasing the surgical morbidity and mortality rate. We still have insufficient data to decide which patient can benefit from a more extended procedure. Standardization of operations, terminology, pathological reporting, and follow-up, together with well-designed prospective studies, will help to decide the operation of choice for pancreatic cancer.
Multiorgan Resection (Including the Pancreas) for Metastasis of Cutaneous Malignant Melanoma
2000
Context Several studies have demonstrated improved survival after complete resection of hollow viscus gastrointestinal metastases of malignant melanoma. Patients with metastatic disease of intra-abdominal solid organs might also benefit from complete surgical resection. Case report The authors report the case of a 22-year-old female patient with multiorgan abdominal metastases of cutaneous malignant melanoma, including the ovarium, jejunum, stomach and pancreas.