title: Gastric adenocarcinoma cutaneous metastasis arising at a previous surgical drain site: a case report.
abstract: BACKGROUND
  Skin metastasis from internal carcinoma rarely occurs. It has an incidence of 0.7 to 9% and it may be the first sign of an unknown malignancy. However, it can also occur during follow-up.
  
  
  METHODS
  A 90-year-old female patient was admitted to our surgical division with a diagnosis of anemia from a bleeding gastric adenocarcinoma. She underwent a gastric resection and Billroth II retrocolic Hofmeister/Finsterer reconstruction. She developed an enteric fistula, which needed a permanent abdominal drain until the 60th postoperative day. After 12 months she was readmitted to our division with subacute small bowel obstruction and an erythematous swelling on the right side of the abdomen. Biopsies characterized it as a cutaneous metastasis from the gastric adenocarcinoma. No surgical therapy was performed given her poor clinical condition.
  
  
  CONCLUSIONS
  Skin metastasis from carcinomas of the upper gastrointestinal tract is very rare. Persisting erythematous nodules must be biopsied in order to diagnose cutaneous metastases and to recognize them early and start prompt therapy with anti-tumour agents before the occurrence of massive visceral metastases.
authors.affiliation: Università degli Studi di Perugia, Clinica Chirurgica Generale e d'Urgenza, Azienda Ospedaliera S, Maria, Terni, Italy. umorelli@libero.it.
authors.forename: Umberto
authors.initials: U
authors.lastname: Morelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
authors.forename: Valerio
authors.initials: V
authors.lastname: Mecarelli
authors.forename: Eriberto
authors.initials: E
authors.lastname: Farinella
authors.forename: Francesco
authors.initials: F
authors.lastname: La Mura
authors.forename: Paolo
authors.initials: P
authors.lastname: Ronca
authors.forename: Gianmario
authors.initials: G
authors.lastname: Giustozzi
authors.forename: Francesco
authors.initials: F
authors.lastname: Sciannameo