Carcinoma of the Pancreas with Cardiac and Cutaneous Metastases: Case Report

Publisher Website
Google Scholar
Abstract
J. F., a white male, aged fifty-seven, was admitted to the Kings County Hospital Nov. 17, 1934, because of pain in the upper abdomen and lower chest. The family and past histories were irrelevant. The patient stated that he had always been in good health until July 1934, at which time he fell, striking his knee and abdomen. Pain developed in the epigastrium and lower chest subsequent to this accident and persisted until the time of admission to the hospital four months later. The pain had no relation to meals and was not relieved by either food or medication. The only gastro-intestinal symptoms were a loss of appetite and severe constipation, with occasional tarry stools. There was slight burning on urination but no other symptoms referable to the genito-urinary tract. The patient appeared to be chronically ill and emaciated. The only positive findings on examination were several hard tender nodes in both axillary, inguinal, and femoral regions. There was slight pain in the anterior chest wall on pressure over the transverse processes of the 10th dorsal to the 3d lumbar vertebrae. The admission diagnosis was metastatic carcinoma of the vertebrae (origin?) with pressure symptoms. Urinalysis was negative. Blood chemistry was normal. The red cell count was 4,200,000; hemoglobin 80 per cent; white cells 6,000. Both the blood and spinal fluid Wassermann reactions were negative. The spinal fluid was under normal pressure and showed no abnormal laboratory findings. The Queckenstedt test was negative. A neurological consultation three days later revealed no subjective or objective sensory disturbances. The only complaint at this time was a constant lancinating pain radiating from the 10th dorsal to the 1st lumbar vertebra, around to the left side of the abdomen. During the following month the patient's condition remained unchanged. Roentgenograms of the gastro-intestinal tract and the entire osseous system revealed no lesions other than some slight irregularity of the first portion of the duodenum, which was interpreted as adhesions around this part of the bowel. No masses were felt other than the enlarged nodes described above. A medical consultant at the time suggested the possibility of a retroperitoneal neoplasm of unknown type. Intrathecal alcohol injections were given for the pain, but only slight, relief was obtained.

This publication has 0 references indexed in Scilit: