A Case of Subcutaneous Recurrent Pancreatic Cancer Occured from Cancer All Seeding Along the Tract of Catheter Duodenostomy

Katsuyuki Kunieda, Shigetoyo Saji, Shinichiro Aoki, Motohisa Kato, Yasuyuki Sugiyama, Hiroshi Takao, Takao Umemoto, Syuji Azuma, Kuniyasu Shimokawa*

Second Department of Surgery, Department of Laboratory Medicine*, Gifu University School of Medicine

We reported a case of pancreatic head cancer showing a very rare pattern of recurrence. A 67-year-old patient was admitted to our hospital with the chief complaint of jaundice. As a past history, he had underwent partial gastrectomy and establishment of a catheter duodenostomy for duodenal ulcer at another hospital one month before this admission. He was diagnosed with pancreatic head cancer by PTC and CT, etc and underwent pancreaticoduodenectomy with Rl lymphadenectomy for stage 4 pancreatic head cancer. However, subcutaneous recurrence was detected on the upper abdominal wall coinciding with the scar of the catheter duodenostomy at three months after the operation. But he gradually deteriorated and died at one year after the first operation. In this case, cancer cells were suspected to be implanted via the catheter duodenostomy as well as the cases of chest wall metastasis implanted along the the fistula of pericutaneous transhepatic biliary drainage.

Key words
pancreatic cancer, cutaneous seeding, deodenostomy

Reprint requests
Katsuyuki Kunieda Second Department of Surgery, Gifu University School of Medicine
40 Tsukasa Machi, Gifu, 500 JAPAN

Accepted
February 9, 1994

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