Skip to main content
Log in

Subcutaneous metastasis at a surgical drain site after the resection of pancreatic cancer

  • Case Report
  • Published:
International Journal of Gastrointestinal Cancer Aims and scope Submit manuscript

Abstract

The aggressive nature of pancreatic cancer makes surgical control of disease an arduous challenge. Tumor seeding during resection is a feared complication during operations performed for this disease. Recurrence within the peritoneal cavity commonly occurs after resection for curative intent. Cutaneous metastasis, however, is a rare event. The majority of skin metastasis reported in the literature occurred after palliative procedures, in which the tumor burden remains. In this report, we describe an unusual case of cutaneous recurrence at the site of a surgical drain after resection for curative intent and discuss the impact of surgery on tumor-growth characteristics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. von Mikulicz J. Small contributions to the surgery of the intestinal tract. Boston Med Surg J 1903;148:608–611.

    Google Scholar 

  2. Ryal C. Cancer infection and cancer recurrence: a danger to avoid in cancer operations. Lance 1907;1311–1316.

  3. Alarcon J, Greenwood GR. Adenocarcinoma of the colon and rectum: a review of surgical treatment in 302 patients. Dis Colon Rectum 1979;22(1):35–39.

    Article  PubMed  CAS  Google Scholar 

  4. Fung MC, Sakata T. What’s new in pancreatic cancer treatment? J Hepatobiliary Pancreat Surg 2002;9(1):61–75.

    Article  PubMed  Google Scholar 

  5. Puri AS, Saraswat VA, Krishnani N, Salunke PN. Cutaneous metastases in pancreatic adenocarcinoma. Indian J Pathol Microbiol 1995;38(1):99–101.

    PubMed  CAS  Google Scholar 

  6. Florez A, Roson E, Sanchez-Aguilar D, et al. Solitary cutaneous metastasis on the buttock: a disclosing sign of pancreatic adenocarcinoma. Clin Exp Dermatol 2000:25(3):201–203.

    Article  PubMed  CAS  Google Scholar 

  7. Miyahara M, Hamanaka Y, Kawabata A, et al. Cutaneous metastaese from pancreatic cancer. Int J Pancreatol 1996;20(2):127–130.

    PubMed  CAS  Google Scholar 

  8. Solin L, Mohiuddin M. Subcutaneous seeding of pancreatic carcinoma along a transhepatic biliary catheter tract. Br J Radiol 1983;56(671):883–884.

    Article  PubMed  CAS  Google Scholar 

  9. Chapman WC, Sharp KW, Weaver F, Sawyers JL. Tumor seeding from percutaneous biliary catheters. Ann Surg 1989;209(6):708–713.

    Article  PubMed  CAS  Google Scholar 

  10. Bergenfeldt M, Genell S, Lindholm K, et al. Needle-tract seeding after percutaneous fine-needle biopsy of pancreatic carcinoma. Case report. Acta Chir Scand. 1988;154(1):77–79.

    PubMed  CAS  Google Scholar 

  11. de Sio I, Castellano L, Calandra M, Del Vecchio-Blanco C. Subcutaneous needle-tract seeding after fine needle aspiration biopsy of pancreatic liver metastasis. Eur J Ultrasound 2002;15(1–2):65–68.

    Article  PubMed  Google Scholar 

  12. Denton KJ, Cotton DW, Nakielny RA, Goepel JR. Secondary tumour deposits in needle biopsy tracks: an underestimated risk? J Clin Pathol 1990;43(1):83.

    Article  Google Scholar 

  13. Lundstedt C, Stridbeck H, Andersson R, Tranberg KG, Andren-Sandberg A. Tumor seeding occurring after fineneedle biopsy of abdominal malignancies. Acta Radiol 1991;32(6):518–520.

    PubMed  CAS  Google Scholar 

  14. Rinaldi R, Nardi F. Cutaneous seeding of a follicular thyroid cancer after fine-needle aspiration biopsy? Diagn Cytopathol 1994;10(2):156–158.

    Article  PubMed  Google Scholar 

  15. Moloo Z, Finley RJ, Lefcoe MS, et al. Possible spread of bronchogenic carcinoma to the chest wall after a transthoracic fine needle aspiration biopsy. A case report. Acta Cytol 1985;29(2):167–169.

    PubMed  CAS  Google Scholar 

  16. Yamaguchi KT, Strong MS, Shapshay SM, Soto E. Seeding of parotid carcinoma along Vim-Silverman needle tract. J Otolaryngol 1979;8(1):49–52.

    PubMed  CAS  Google Scholar 

  17. Grabau DA, Andersen JA, Graversen HP, Dyreborg U. Needle biopsy of breast cancer. Appearance of tumour cells along the needle track. Eur J Surg Oncol 1993;19(2):192–194.

    PubMed  CAS  Google Scholar 

  18. Steinmetz MP, Barnett GH, Kim BS, et al. Metastatic seeding of the stereotactic biopsy tract in glioblastoma multiforme: case report and review of the literature. J Neurooncol 2001;55(3):167–171.

    Article  PubMed  CAS  Google Scholar 

  19. Horino K, Hiraoka T, Kanemitsu K, et al. Subcutaneous metastases after curative resection for pancreatic carcinoma: a case report and review of the literature. Pancreas 1999;19(4):406–408.

    Article  PubMed  CAS  Google Scholar 

  20. Whelan RL, Allendorf JD, Gutt CN, et al. General oncologic effects of the laparoscopic surgical approach. 1997 Frankfurt international meeting of animal laparoscopic researchers. Sur Endosc 1998;12:1092–1095.

    Article  CAS  Google Scholar 

  21. Lacy A, Garcia-Valdecasas J, Delgado S, et al. Postoperative complications of laparoscopic-assisted colectomy. Surg Endosc 1997;11:119–122.

    Article  PubMed  CAS  Google Scholar 

  22. Larach S, Patankar S, Ferrara A, et al. Complications of laparoscopic colorectal surgery: analysis and comparison of early vs. latter experience. Dis Colon Rectum 1997;40:592–596.

    Article  PubMed  CAS  Google Scholar 

  23. Shoup M, Brennan MF, Karpeh MS, et al. Port site metastasis after diagnostic laparoscopy for upper gastrointestinal tract malignancies: an uncommon entity. Ann Surg Oncol 2002;9(7):632–636.

    Article  PubMed  Google Scholar 

  24. Agostini A, Robin F, Jais JP, Aggerbeck M, Vilde F, Blanc B, Lecuru F. Peritoneal closure reduces port site metastases: results of an experiment in a rat ovarian cancer model. Surg Endosc 2002;16(2):289–291.

    Article  PubMed  CAS  Google Scholar 

  25. Wenger FA, Kilian M, Braumann C, et al. Effects of taurolidine and octreotide on port site and liver metastasis after laparoscopy in an animal model of pancreatic cancer. Clin Exp Metastasis 2002;19(2):169–173.

    Article  PubMed  CAS  Google Scholar 

  26. Gupta A, Watson DI, Ellis T, Jamieson GG. Tumour implantation following laparoscopy using different insufflation gases. ANZ J Surg 2002;72(4):254–257.

    Article  PubMed  Google Scholar 

  27. Wenger FA, Jacobi CA, Kilian M, et al. The impact of laparoscopic biopsy of pancreatic lymph nodes with helium and carbon dioxide on port site and liver metastasis in BOP-induced pancreatic cancer in hamster. Clin Exp Metastasis 2000;18(1):11–14.

    Article  PubMed  CAS  Google Scholar 

  28. Follman J. Angiogenesis inhibitors generated by tumors. Mol Med. 1995;1(2):120–122.

    Google Scholar 

  29. O’Reilly MS, Boehm T, Shing Y, et al. Endostatin: an endogenous inhibitor of angiogenesis and tumor growth. Cell 1997;88(2):277–285.

    Article  PubMed  CAS  Google Scholar 

  30. Kisher O, Onizuka S, Banyard J, et al. Generation of multiple angiogenesis inhibitors by human pancreatic cancer. Cancer Res 2001;61(19):7298–7304.

    Google Scholar 

  31. Tseng JF, Farnebo FA, Kisker O, et al. Adenovirus-mediated delivery of a soluble form of the VEGF receptor Flk1 delays the growth of murine and human pancreatic adenocarcinoma in mice. Surgery 2002;132(5):857–865.

    Article  PubMed  Google Scholar 

  32. Steenfos HH. Growth factors and wound healing. Scand J Plast Reconstr Surg Hand Surg 1994;28(2):95–105.

    Article  PubMed  CAS  Google Scholar 

  33. Hofer SO, Molema G, Hermens RA, et al. The effect of surgical wounding on tumour development. Eur J Surg Oncol 1999;25(3):231–243.

    Article  PubMed  CAS  Google Scholar 

  34. Bogden AE, Moreau JP, Eden PA. Proliferative response of human and animal tumours to surgical wounding of normal tissues: onset, duration and inhibition. Br J Cancer 1997;75(7):1021–1027.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Adyr A. Moss MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

St. Peter, S.D., Nguyen, C.C., Mulligan, D.C. et al. Subcutaneous metastasis at a surgical drain site after the resection of pancreatic cancer. Int J Gastrointest Canc 33, 111–115 (2003). https://doi.org/10.1385/IJGC:33:2-3:111

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1385/IJGC:33:2-3:111

Key Words

Navigation