Wednesday, September 28, 2022

Rare case of soft tissue metastasis of pancreatic adenocarcinoma reported after curative resection

The medical literature indicates that pancreatic adenocarcinoma is the most common type of pancreatic cancer.

Xial T1-weighted magnetic resonance imaging sequence shows a low signal intensity homogeneous tumor (white arrow). Photo: Courtesy of the researchers in the study.

This is a case that surprised the specialists treating the patient, as soft tissue metastases from primary carcinomas are rare lesions, and are often the first clinical manifestation of a previously unknown malignant neoplasm of an advanced stage. Presents alone in the setting of recurrent disease.

They highlighted that soft tissue metastases from pancreatic adenocarcinoma are extremely rare, even noting that few cases involving the skin have been described in the literature, and range from solitary metastases to deep soft tissue. (eg, subcutis and skeletal muscle) have been reported. 10 times.

Case presented with late-onset subcutaneous metastasis (recurrent disease) in a 74-year-old female, alone in the posterior aspect of the left thigh, derived from adenocarcinoma of the pancreatic head, 2 years after initial treatment with R0 resection or Pancreatoduodenectomy is a procedure performed to treat tumors and disorders related to the intestine, pancreas, and bile duct, or adjuvant chemotherapy.

As reported in the published study, these scenarios are associated with poor prognosis and may be a source of clinical confusion, both clinical and pathological. “The main site of malignant neoplasms is usually the lung, breast, kidney, or colon,” he says.

The researchers emphasize that because of the rarity of this unit, they reviewed the literature and discussed treatment options, our patient’s good general condition and symptoms (local pain), favorable location (thigh) and small size of the tumor. Considering the size. (less than 4 cm in diameter), and the absence of recurrent disease at additional sites, the decision was made to perform an excisional biopsy of the lesion instead of a core needle biopsy.

Histopathological analysis of the specimen revealed a metastatic lesion of adenocarcinoma, therefore, additionally, investigators considered an additional immunohistochemical analysis unnecessary because of the patient’s clinical history (known adenocarcinoma of the pancreas).

“Although distant metastases from pancreatic adenocarcinoma generally have a poor prognosis, there is insufficient data in the literature on the route, treatment and prognosis of an isolated late-onset soft tissue metastasis due to the rarity of this metastasis. unit,” he described .

To ease the patient’s symptoms, experts indicated that additional chemotherapy appears to be the ideal treatment option. “Whether this option will lead to longer survival has not yet been addressed, but after 8 months, our patient remains disease free,” he notes.

In summary, soft tissue metastases from primary carcinoma are rare, and in most cases the primary malignancy is carcinoma of the lung, kidney or colon.

Another aspect highlighted is that although hematogenous dissemination of pancreatic adenocarcinoma is generally associated with a poor prognosis, cases such as ours “reveal the importance of wound resection for diagnostic and palliative purposes and There appears to be a reasonable treatment option for long-term survival.

Access the case here.

Nation World News Desk
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