Solitary Soft-Tissue Metastasis of a Pancreatic Adenocarcinoma 2 Years After Curative Resection: Report of a Rare Case and a Literature Review

Abstract

Patient: Female, 74-year-old Final Diagnosis: Soft tissue metastasis from pancreatic adenocarcinoma Symptoms: Palpable, hard and painful mass, with rapid growth, located in the posterior aspect of the upper left thigh Medication: — Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Soft-tissue metastases from a primary carcinoma are rare lesions. They often are the first clinical manifestation of a previously unknown malignancy of an advanced stage, but may also be solitary in a setting of a recurrent disease. Generally, they are associated with poor prognosis and may be the source of diagnostic confusion both clinically and pathologically. The primary location of the malignancy is usually lung, breast, kidney, or colon. Soft-tissue metastases from a pancreatic adenocarcinoma are extremely rare. A few cases involving the skin have been described in the literature, and solitary metastasis to the deep soft-tissue (eg, subcutis and skeletal muscle) was reported less than 10 times. Case Report: We report the case of a 74-year-old woman who presented with late-onset (recurrent disease), solitary, subcutaneous metastasis in the posterior aspect of the left thigh, deriving from a pancreatic head adenocarcinoma, 2 years after initial treatment with R0 resection (pancreaticoduodenectomy) and adjuvant chemotherapy. We emphasize the rarity of this entity, review the literature, and discuss treatment options. Conclusions: Solitary soft-tissue metastasis from a pancreatic adenocarcinoma after initial curative treatment is very rare. Although hematogenous spread from a pancreatic adenocarcinoma generally has a very poor prognosis, treatment should be individualized according to the patient’s history, general condition, and symptoms and the clinical setting in relation to the primary disease.