Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2020; 12(11): 1372-1380
Published online Nov 15, 2020. doi: 10.4251/wjgo.v12.i11.1372
Cutaneous metastases of pancreatic carcinoma to the labia majora: A case report and review of literature
Ying Shi, Shan-Shan Li, Dan-Yan Liu, Yan Yu
Ying Shi, Yan Yu, Department of Dermatology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Shan-Shan Li, Department of Dermatology and Venereology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Dan-Yan Liu, Department of Radiology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: All authors contributed equally to this paper with the conception and design of the study, literature review and analysis, manuscript drafting, critical revision, and editing, and approval of the final version.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: All the authors are aware of the content of the manuscript and have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Yan Yu, MD, Chief Doctor, Department of Dermatology, First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, Jilin Province, China.
Received: August 12, 2020
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

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.

Keywords: Pancreatic cancer, Cutaneous, Metastasis, Non-umbilical, Biomarker, Case report

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.