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[Metastatic cutaneous adenocarcinoma of unknown primary site. Case report]
Caio Sergio Rizkallah Nahas1, Marcos Túlio Martino Meniconi, Dario Birolini
1Serviço de Cirurgia de Emergência, Divisão Cirúrgica III, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Botucatu, SP. caionahas@uol.com.br
Background:
Metastases may be the first manifestation of adenocarcinoma. Up to 60% are cutaneous and present in advanced stage neoplasms. Research for the primary site is costly and requires endoscopy, imaging and immunohistochemical exams. The primary site becomes obvious in only 15% to 20% of live patients and is detected mainly at autopsy.
Aim:
To report a case of metastatic cutaneous moderately differentiated adenocarcinoma of unknown primary site, located in the lower left abdomen.
Results:
The lesion was surgically resected. Primary site was not found by any imaging or endoscopy exams. The immunohistochemistry was negative for CEA, CK20, PSA and positive for CK7. Based on these exams, prostate and colorectal cancer were excluded. The pancreas and biliary tract were considered as the probable primary site.
Conclusion:
The research for the primary site still is difficult, expensive and is not effective to the treatment of metastatic adenocarcinomas.
