title: Acral metastasis in a patient with ampullary carcinoma.
abstract: Although skin metastasis from a malignant tumor of an internal organ usually occurs at an advanced disease stage, there has been no prior report of a cutaneous acral metastasis from ampullary carcinoma to date. We report a 71-year old male patient with cutaneous metastasis from an ampullary adenocarcinoma. The patient had a history of pylorus preserving pancreaticoduodenectomy for carcinoma of the ampulla of Vater two years prior to presentation. Physical examination revealed ill-defined, painful and hard erythematous nodules at the left thumb and distal phalanx of the right middle finger. The computed tomography scan showed low density masses in the retroperitoneum; the histological examination of a nodule from the right middle finger showed a metastatic adenocarcinoma. This case illustrates that cutaneous metastasis from ampullary carcinoma has a poor prognosis.
authors.affiliation: Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Cho
authors.forename: Tae Hyeon
authors.initials: TH
authors.lastname: Kim
authors.forename: Seok Don
authors.initials: SD
authors.lastname: Park
authors.forename: Ki Jung
authors.initials: KJ
authors.lastname: Yun
authors.forename: Suck Chei
authors.initials: SC
authors.lastname: Choi
authors.forename: Haak Cheoul
authors.initials: HC
authors.lastname: Kim
authors.forename: Yong Ho
authors.initials: YH
authors.lastname: Nah
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology*; D003138:Common Bile Duct Neoplasms / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D011379:Prognosis; D012878:Skin Neoplasms / Q000556:secondary*