Gastric adenocarcinoma cutaneous metastasis arising at a previous surgical drain site: a case report.
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.
Morelli
Umberto
U
Università degli Studi di Perugia, Clinica Chirurgica Generale e d'Urgenza, Azienda Ospedaliera S, Maria, Terni, Italy. umorelli@libero.it.
Cirocchi
Roberto
R
Mecarelli
Valerio
V
Farinella
Eriberto
E
La Mura
Francesco
F
Ronca
Paolo
P
Giustozzi
Gianmario
G
Sciannameo
Francesco
F