Pancreatic panniculitis polyarthritis syndrome

45^th Euro-Global Summit on Cancer Therapy & Radiation Oncology

November 27-28, 2023 Paris, France

Reshma Kannanpuzha Jayachandran, Praneshan Moodley and Geraldine Quinterro

University Hospitals Plymouth NHS Trust, United Kingdom

Scientific Tracks Abstracts: J Cancer Sci Ther

Abstract :

A 73 year old male presented to hospital with painful reddish lumps on both legs. New lumps emerged over the course of days to weeks before admission. There was poor response to courses of antibiotics from his GP. Even a course of steroids from a Dermatologist did not seem to help. He had metastatic prostate cancer, previous pancreatic cancer, emphysema, hypertension and peripheral vascular disease. He was on lifelong anti-androgen therapy for his prostate cancer, which remained quiescent. For his pancreatic cancer, he underwent a Whipple’s procedure and completed chemotherapy with Gemicitabine. In hospital, he was treated with antibiotics for a suspected soft tissue infection. Multiple disciplines were involved in his care including Dermatology, Oncology, Rheumatology, and Orthopaedics (for joint involvement). Blood cultures were negative despite ongoing fevers and joint aspiration excluded septic arthritis. Biopsy of skin lesions revealed fat necrosis. Serum lipase was markedly elevated. A CT scan revealed significant progressive hepatic metastatic disease. The clinical features were consistent with pancreatitis, panniculitis, polyarthritis syndrome. An Octreotide infusion (initially 500mcg over 24 hours) was trialed with the intention of suppressing the secretion of pancreatic enzymes. Pancreatic panniculitis is an infrequent, predominantly lobular panniculitis that develops in individuals with pancreatic disease. The commonest associated disorders are acute and chronic pancreatitis, but it can also be seen in pancreatic malignancy. Unless a high degree of suspicion is maintained, the non-specific nature of these skin lesions makes the diagnosis challenging. Multi-disciplinary involvement from an early stage is important to establish a unifying diagnosis.

Biography :

Reshma Kannanpuzha Jayachandran is a junior doctor at the General Internal Medicine Department at Derriford Hospital, Plymouth, UK. She is a recipient of many awards and grants for her valuable contributions and discoveries in major area of subject research. Her international experience includes various programs, contributions and participation in different countries for diverse fields of study. Her research interests reflect in her wide range of publications in various national and international journals.