Published online Nov 15, 2020. doi: 10.4251/wjgo.v12.i11.1372
Peer-review started: August 12, 2020
First decision: September 16, 2020
Revised: September 29, 2020
Accepted: October 19, 2020
Article in press: October 19, 2020
Published online: November 15, 2020
Processing time: 91 Days and 14.4 Hours
Cutaneous metastases originating from pancreatic cancer are relatively rare. The most common reported site of metastasis is the umbilicus, and this manifestation is known as the Sister Mary Joseph’s nodule. Non-umbilical cutaneous metastases are far less common, with only a few cases reported in the literature. Our case is the first case report, to our knowledge, on metastasis involving the labia majora and flat papules.
A 49-year-old Chinese female patient presented with a number of red, swollen papules on the vulva for 2 mo. Histological examination of the labia majora lesion revealed metastatic adenocarcinoma. The serum levels of tumor biomarkers CA199, CA242, and CA125 were significantly elevated. B-mode ultrasound-guided needle biopsy of the pancreas demonstrated moderately and poorly differentiated adenocarcinoma. The patient finally declined treatment for financial reasons and died 3 mo later.
Metastatic cutaneous lesions could indicate pancreatic cancer. Serum levels of tumor biomarkers may aid in diagnosing metastatic pancreatic adenocarcinoma.
Core Tip: Cutaneous metastasis from pancreatic cancer is uncommon. The most common site of the skin lesion is the umbilicus. The majority of skin lesions are singular, particularly in patients exhibiting the Sister Mary Joseph’s nodule. We describe an unusual case of flat papules on the labia majora that metastasized from pancreatic cancer. The lesion was the first sign of metastatic disease, and serum levels of CA199, CA242, and CA125 were also elevated. We report this case to improve the understanding of cutaneous metastasis of pancreatic cancer and emphasize the importance of serum levels of CA199, CA242, and CA125 in diagnosing pancreatic cancer.