title: Cutaneous metastasis of pancreatic adenocarcinoma after kidney transplant: a case report and review of the literature.
abstract: OBJECTIVE
  Pancreatic cancer is one of the most lethal human cancers. Each year in the United States, about 42 470 individuals are diagnosed with this condition, and 35 240 die, despite advances in imaging, medical treatment, and surgical intervention. Often, 80% to 90% of pancreatic cancers are diagnosed at the locally advanced or metastatic stage. However, cutaneous metastases originating from pancreatic cancer are rare. If cutaneous metastases do indeed occur, it is often near the umbilicus, known as the Sister Mary Joseph's nodule. Nonumblical cutaneous metastases are rare, with only several cases reported, but none regarding lesions after organ transplant. We introduce the first reported case of a cutaneous metastatic lesion of pancreatic adenocarcinoma after the transplant of an organ. We also performed a literature review and an analysis of reported cases of nonumblical cutaneous metastases of pancreatic adenocarcinoma.
  
  
  METHODS
  We performed a MEDLINE and PubMed search of reported nonumblical cutaneous metastases of pancreatic adenocarcinoma since 1980 after a literature review and analysis.
  
  
  RESULTS
  Our case involved a 76-year-old woman who developed cutaneous pancreatic adenocarcinoma metastases in her surgical wound 2 years after a bilateral kidney transplant. This is the first case of pancreatic adenocarcinoma cutaneous metastases after an organ transplant.
  
  
  CONCLUSIONS
  The death rate from cancer has increased as the population has aged. This also holds true for transplant recipients. Some believe that cancer will soon surpass cardiovascular disease as the major cause of mortality after transplant. Therefore, it is incumbent upon us to appropriately screen patients with age-appropriate evidence-based examinations. Additionally, those patients with suspicious presentations should be judiciously evaluated to discover a cure for cancer as quickly as possible.
authors.affiliation: Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA. pont0035@umn.edu
authors.forename: Thomas
authors.initials: T
authors.lastname: Pontinen
authors.forename: Alyson
authors.initials: A
authors.lastname: Melin
authors.forename: Gabor
authors.initials: G
authors.lastname: Varadi
authors.forename: Kamran
authors.initials: K
authors.lastname: Khanmoradi
authors.forename: Daranee
authors.initials: D
authors.lastname: Chewaproug
authors.forename: Shiang Cheng
authors.initials: SC
authors.lastname: Kung
authors.forename: Radi
authors.initials: R
authors.lastname: Zaki
authors.forename: Jorge
authors.initials: J
authors.lastname: Ortiz
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001706:Biopsy; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D012878:Skin Neoplasms / Q000188:drug therapy / Q000556:secondary*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine