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Cutaneous metastasis from pancreatic cancer: A case report and systematic review of the literature.

Zhou HY, Wang XB, Gao F, Bu B, Zhang S, Wang Z - Oncol Lett (2014)

Bottom Line: Treatment strategies including surgery, radiation, chemotherapy or a combination improved survival time from 3.0 to 8.3 months.Metastasis to the skin indicates a widespread, general dissemination and a poor prognosis.A combination of surgery, radiotherapy and chemotherapy appears to result in improved survival rates.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China.

ABSTRACT
Cutaneous metastasis from pancreatic cancer is uncommon, therefore, the outcome of this progression has rarely been investigated. The aim of the present report was to evaluate the clinical characteristics of patients exhibiting cutaneous metastasis from pancreatic cancer. Thus, the current report presents a rare case of cutaneous metastatic disease from pancreatic cancer and describes a systematic review of the literature. A total of 54 articles comprising 63 cases were included for analysis. The relevant clinical and pathological characteristics, as well as the treatment strategies and survival outcomes of this rare disease presentation were reviewed. The average patient was was aged 63.9 years and males constituted a marginally greater proportion of the cohort (61.9%). The predominant manifestation of the cutaneous metastasis was a nodule or mass (73%) and the most common site of the skin lesion was non-umbilicus rather than umbilicus. The majority (66.7%) of the skin lesions were singular, particularly in patients exhibiting Sister Mary Joseph's nodule (90%). A wide range of histological subtypes presented, with a predominance of adenocarcinoma (84.1%). Of the cases that specified the tumor differentiation grade, 78.2% were moderately or poorly differentiated. Immunohistochemistry revealed that cytokeratin (CK)20-negative, and CK7-, CK19- and carbohydrate antigen (CA)19-9-positive were specific diagnostic markers for pancreatic cancer. Distal metastases, excluding the skin, were observed in 68.3% of patients and the median survival period was 5 months. Treatment strategies including surgery, radiation, chemotherapy or a combination improved survival time from 3.0 to 8.3 months. Cutaneous metastasis from pancreatic cancer is a rare finding, often providing the only external indication of an internal malignancy and, therefore, should be considered in the differential diagnosis of skin lesions. Metastasis to the skin indicates a widespread, general dissemination and a poor prognosis. A combination of surgery, radiotherapy and chemotherapy appears to result in improved survival rates.

No MeSH data available.


Related in: MedlinePlus

Survival curves of patients exhibiting cutaneous metastasis of pancreatic cancer grouped by therapy, age, gender and number of skin lesions. (A) Survival time of patients who underwent therapy improved significantly in comparison to patients who did not undergo therapy. However, survival time following skin metastasis was not significantly different between (B) patients <65 years and patients >65 years, (C) males and females or (D) patients with a single skin lesion and patients with multiple skin lesions. P<0.05 indicates a statistically significant difference.
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f5-ol-08-06-2654: Survival curves of patients exhibiting cutaneous metastasis of pancreatic cancer grouped by therapy, age, gender and number of skin lesions. (A) Survival time of patients who underwent therapy improved significantly in comparison to patients who did not undergo therapy. However, survival time following skin metastasis was not significantly different between (B) patients <65 years and patients >65 years, (C) males and females or (D) patients with a single skin lesion and patients with multiple skin lesions. P<0.05 indicates a statistically significant difference.

Mentions: Treatment consisted of chemotherapy in 20 cases, surgery in 15 cases and radiotherapy in six cases. The survival period was evaluated in 42 patients and ranged from a few days to ~19 months, with a median value of five months (Fig. 4). Therapy, including surgery, chemotherapy, radiation or a combination improved the survival time from 3.0 to 8.3 months (P=0.004; Fig. 5A). Younger patients (aged <65 years) exhibited improved survival when compared with those aged >65 years, with a mean survival time of 7.0 vs. 5.1 months, respectively; however, the difference was not identified to be significant (P=0.315; Fig. 5B). Gender and the number of skin lesions had no influence on overall patient survival (Fig. 5C and D).


Cutaneous metastasis from pancreatic cancer: A case report and systematic review of the literature.

Zhou HY, Wang XB, Gao F, Bu B, Zhang S, Wang Z - Oncol Lett (2014)

Survival curves of patients exhibiting cutaneous metastasis of pancreatic cancer grouped by therapy, age, gender and number of skin lesions. (A) Survival time of patients who underwent therapy improved significantly in comparison to patients who did not undergo therapy. However, survival time following skin metastasis was not significantly different between (B) patients <65 years and patients >65 years, (C) males and females or (D) patients with a single skin lesion and patients with multiple skin lesions. P<0.05 indicates a statistically significant difference.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214468&req=5

f5-ol-08-06-2654: Survival curves of patients exhibiting cutaneous metastasis of pancreatic cancer grouped by therapy, age, gender and number of skin lesions. (A) Survival time of patients who underwent therapy improved significantly in comparison to patients who did not undergo therapy. However, survival time following skin metastasis was not significantly different between (B) patients <65 years and patients >65 years, (C) males and females or (D) patients with a single skin lesion and patients with multiple skin lesions. P<0.05 indicates a statistically significant difference.
Mentions: Treatment consisted of chemotherapy in 20 cases, surgery in 15 cases and radiotherapy in six cases. The survival period was evaluated in 42 patients and ranged from a few days to ~19 months, with a median value of five months (Fig. 4). Therapy, including surgery, chemotherapy, radiation or a combination improved the survival time from 3.0 to 8.3 months (P=0.004; Fig. 5A). Younger patients (aged <65 years) exhibited improved survival when compared with those aged >65 years, with a mean survival time of 7.0 vs. 5.1 months, respectively; however, the difference was not identified to be significant (P=0.315; Fig. 5B). Gender and the number of skin lesions had no influence on overall patient survival (Fig. 5C and D).

Bottom Line: Treatment strategies including surgery, radiation, chemotherapy or a combination improved survival time from 3.0 to 8.3 months.Metastasis to the skin indicates a widespread, general dissemination and a poor prognosis.A combination of surgery, radiotherapy and chemotherapy appears to result in improved survival rates.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China.

ABSTRACT
Cutaneous metastasis from pancreatic cancer is uncommon, therefore, the outcome of this progression has rarely been investigated. The aim of the present report was to evaluate the clinical characteristics of patients exhibiting cutaneous metastasis from pancreatic cancer. Thus, the current report presents a rare case of cutaneous metastatic disease from pancreatic cancer and describes a systematic review of the literature. A total of 54 articles comprising 63 cases were included for analysis. The relevant clinical and pathological characteristics, as well as the treatment strategies and survival outcomes of this rare disease presentation were reviewed. The average patient was was aged 63.9 years and males constituted a marginally greater proportion of the cohort (61.9%). The predominant manifestation of the cutaneous metastasis was a nodule or mass (73%) and the most common site of the skin lesion was non-umbilicus rather than umbilicus. The majority (66.7%) of the skin lesions were singular, particularly in patients exhibiting Sister Mary Joseph's nodule (90%). A wide range of histological subtypes presented, with a predominance of adenocarcinoma (84.1%). Of the cases that specified the tumor differentiation grade, 78.2% were moderately or poorly differentiated. Immunohistochemistry revealed that cytokeratin (CK)20-negative, and CK7-, CK19- and carbohydrate antigen (CA)19-9-positive were specific diagnostic markers for pancreatic cancer. Distal metastases, excluding the skin, were observed in 68.3% of patients and the median survival period was 5 months. Treatment strategies including surgery, radiation, chemotherapy or a combination improved survival time from 3.0 to 8.3 months. Cutaneous metastasis from pancreatic cancer is a rare finding, often providing the only external indication of an internal malignancy and, therefore, should be considered in the differential diagnosis of skin lesions. Metastasis to the skin indicates a widespread, general dissemination and a poor prognosis. A combination of surgery, radiotherapy and chemotherapy appears to result in improved survival rates.

No MeSH data available.


Related in: MedlinePlus