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. 2023 Jan;12(1):179-188.
doi: 10.1002/cam4.4916. Epub 2022 Jun 6.

Pancreatic cancer: Cutaneous metastases, clinical descriptors and outcomes

Lilly Gu  1   2 , Paras P Mehta  1 , Devika Rao  3 , Veronica Rotemberg  4 , Marinela Capanu  5 , Joanne Chou  5 , Sabrina Lin  5 , Carlie S Sigel  6 , Klaus J Busam  6 , Lindsay Boyce  7 , Allison Gordon  4 , Eileen M O'Reilly  2   3   8
Affiliations

Pancreatic cancer: Cutaneous metastases, clinical descriptors and outcomes

Lilly Gu et al. Cancer Med. 2023 Jan.

Abstract

Background: Cutaneous metastases in pancreatic cancer (PC) are rare. Herein, we evaluate the clinical, genomic, and other descriptors of patients with PC and cutaneous metastases.

Methods: Institutional databases were queried, and clinical history, demographics, PC cutaneous metastasis details, and overall survival (OS) from cutaneous metastasis diagnosis were abstracted. OS was estimated using Kaplan-Meier methods.

Results: Forty patients were identified, and median age (Q1-Q3, IQR) of PC diagnosis was 66.0 (59.3-72.3, 12.9) years. Most patients had Stage IV disease at diagnosis (n = 26, 65%). The most common location of the primary tumor was the tail of the pancreas (n = 17, 43%). The most common cutaneous metastasis site was the abdomen (n = 31, 78%), with umbilical lesions occurring in 74% (n = 23) of abdominal lesions. The median OS (95% CI) was 11.4 months (7.0, 20.4). Twenty-three patients had umbilical metastases (58%), and 17 patients had non-umbilical metastases (43%). The median OS (95% CI) was 13.7 (7.0, 28.7) months in patients with umbilical metastases and 8.9 (4.1, Not reached) months in patients with non-umbilical metastases (p = 0.1). Sixteen of 40 (40%) patients underwent somatic testing, and findings were consistent with known profiles. Germline testing in 12 (30%) patients identified pathogenic variants in patients: CHEK2, BRCA1, and ATM.

Conclusion: Cutaneous metastases from PC most frequently arise from a pancreas tail primary site and most frequently occur in the umbilicus. Cutaneous metastases may generally be categorized as umbilical or non-umbilical metastases.

Keywords: Sister Mary Joseph nodule; cutaneous metastasis; pancreatic cancer; umbilical nodule.

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Conflict of interest statement

LG: None; PM: None; DR: None; VR: : Inhabit Brands, Inc.; MC: None; JC: None; SL: None; CS: None; KB: : Dermtech; : Elsevier, Springer; LB: None; AG: None; EMO'R: : Genentech/Roche, Celgene/BMS, BioNTech, BioAtla, AstraZeneca, Arcus, Elicio, Parker Institute, AstraZeneca; : Cytomx Therapeutics (DSMB), Rafael Therapeutics (DSMB), Silenseed, Tyme, Seagen, Molecular Templates, Boehringer Ingelheim, BioNTech, Ipsen, Polaris, Merck, IDEAYA, AstraZeneca, Noxxon, BioSapien, Cend Therapeutics, Thetis, Bayer (spouse), Genentech‐Roche (spouse), Celgene‐BMS (spouse), Eisai (spouse).

Figures

FIGURE 1
FIGURE 1
Cohort diagram.
FIGURE 2
FIGURE 2
Overall survival curves from pancreatic cancer cutaneous metastases. (A) Overall survival of total cohort (n = 40). (B) Overall survival stratified by umbilical metastases and non‐umbilical metastases (p = 0.1).
FIGURE 3
FIGURE 3
Cutaneous umbilical metastasis from pancreatic cancer. (A) Clinical appearance of a cutaneous umbilical metastasis, described as a violaceous to red umbilical papulonodule. (B) The microscopic findings of the skin biopsy show infiltration of the dermis by a ductal adenocarcinoma. Its microscopic features are consistent with a pancreatic origin.
FIGURE 4
FIGURE 4
Cutaneous non‐umbilical metastasis from pancreatic cancer. (A) Clinical appearance of a cutaneous neck metastasis, described as a pink, scaly, eroded papulonodule. (B) Histopathologically, there is a moderately to poorly differentiated adenocarcinoma in the dermis. (C) The tumor cells are immunoreactive for cytokeratin 7.
See this image and copyright information in PMC

References

    1. Rawla P, Sunkara T, Gaduputi V. Epidemiology of pancreatic cancer: global trends, etiology and risk factors. World J Oncol. 2019;10(1):10‐27. doi:10.14740/wjon1166 - DOI - PMC - PubMed
    1. Park W, Chawla A, O'Reilly EM. Pancreatic cancer: a review. JAMA. 2021;326(9):851‐862. doi:10.1001/jama.2021.13027 - DOI - PMC - PubMed
    1. Cubilla A, Fitzgerald PJ. Pancreas cancer. I. Duct adenocarcinoma. A clinical‐pathologic study of 380 patients. Pathol Annu. 1978;13 Pt 1:241‐289. - PubMed
    1. Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol. 1993;29(2 Pt 1):228‐236. doi:10.1016/0190-9622(93)70173-q - DOI - PubMed
    1. Brownstein MH, Helwig EB. Metastatic tumors of the skin. Cancer. 1972;29(5):1298‐1307. doi:10.1002/1097-0142(197205)29:5<1298::aid-cncr2820290526>3.0.co;2-6 - DOI - PubMed

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