[A case of abdominal wall metastasis from pancreatic cancer]

A 74-year-old woman underwent laparotomy for pancreatic cancer, which revealed peritoneal dissemination. Then, gastrojejunostomy was performed. After the operation, multiple liver metastases were detected by CT scanning. However, there were no findings suggestive of peritoneal dissemination. The patient was treated with chemotherapy of gemcitabine plus S-1. At the end of five courses, the primary lesion and liver metastases decreased in size. Nevertheless, a painful hard tumor was noticed at the scar of the previous operation in the upper abdomen. Biopsy examination revealed adenocarcinoma. Accordingly, abdominal wall metastasis from pancreatic cancer was diagnosed. We speculated that the abdominal wall metastasis grew by implantation into the scar because good control of the primary lesion and liver metastasis was maintained. As no effective secondary therapy was established, chemotherapy with gemcitabine plus S-1 was continuously administered. At the end of 7 courses, the patient died of progressive peritoneal dissemination. Metastasis to the abdominal wall has been rarely reported. Moreover, the available literature contains only two reports on such metastasis from pancreatic cancer. We report herein this rare case, together with some bibliographical comments.