dear sebastian
resection of metastases has only the palliative role only if the patient has symptom., otherwise disease is in metastatic setting and according the NCCN ,surgery has only palliative role.
Dear Sebastian,
A paper that may interest you:
Curr Oncol. 2010 Nov; 17(6): 78–81.
Umbilical metastasis: a case series of four Sister Joseph nodules from four different visceral malignancies
M. Palaniappan et al.
.......Mean life expectancy is 2–11 months without treatment. Recent reports have suggested that prognosis is better with aggressive management, the mean survival being 17.6–21 months with surgery and adjuvant chemotherapy. But surgery is usually recommended only in patients with a solitary umbilical metastasis. Surgery should be avoided in cases with widespread disseminated disease; in such cases, effective palliation can be achieved with chemoradiotherapy. The aggressive strategies belie the traditional concept that patients, once diagnosed with Sister Mary Joseph nodule (smjn) should receive supportive care only. However, prognosis also depends on the primary lesion type and the organ affected. It has been noted that patients with ovarian cancer have a better survival rate than do patients with other malignancies............
Metastatic vs primary malignant neoplasms affecting the umbilicus: clinicopathologic features of 77 tumors
John A. Papalas, Maria A. Selim,
Annals of Diagnostic Pathology
Volume 15, Issue 4, August 2011, Pages 237–242
Abstract
Periumbilical skin is unique due to its proximity to intra-abdominal and pelvic structures. In addition to primary skin malignancies, it is a site often involved with metastatic disease. We reviewed the clinical and pathologic features of 77 umbilical malignancies occurring at our institution since 1988. Seventy-seven patients were identified (female/male ratio, 4.1:1.0) with the average age for women being 63 years and 55 years for men. Eighty-eight percent of malignancies originated outside the umbilicus and 12% were primary skin tumors. Fifty-eight (85%) patients with metastatic tumors had umbilical involvement from a known primary vs 10 (15%) with unknown primaries. Nine patients with metastatic tumors to the umbilicus would present with solitary umbilical involvement. Of these patients, 56% would not have a primary site assigned to their metastatic disease. In women, the 3 most common primary sites were the ovary, endometrium, and pancreatobiliary tree, whereas for men, it was the genitourinary tract, pancreatobiliary tree, and the gastrointestinal tract. Of the primary umbilical malignancies, 44% of patients were male and 56% female. Malignant melanoma was the most common primary umbilical malignancy. In summary, women are more likely than men to have malignant tumors affecting the umbilicus. Overall, the most likely primary site of a metastatic tumor to the umbilicus is the genitourinary tract. Rarely, patients present with metastatic tumors to the umbilicus, and most of these patients will not have a primary site of tumor origin assigned
The metastasis to umbilica is a sign of cancer progresion and its resection can only be palliative. decision about Rt Or CT depends on the stage of involvement.
I reported the same case titled ” A case of advanced pancreatic cancer with remarkable response to thalidomide, celecoxib and gemcitabine”.
65 years old male came to our hospital complaining of dirty exudate from umbilicus.
His diagnosis was metastatic pancreatic cancer with peritonitis carcinomatosa before coming to our hospital. We could follow the patient for 1 year and 3months.
Article [A case of advanced pancreatic cancer with remarkable respon...
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