[Clinical Picture] New subcutaneous nodules and joint pain in a patient with pancreatic cancer
Summary
A 51-year-old man with advanced pancreatic cancer presented to General Hospital of Southern Theater Command (Guangzhou, China) in December, 2025, with a 3-week history of rapidly spreading, painful subcutaneous nodules (figure A), and bilateral knee pain. He was on maintenance oral tegafur after initial response to FOLFIRINOX. His knee pain, initially managed as gout given his history, was unresponsive to treatment.…
A 51-year-old man with advanced pancreatic cancer presented to General Hospital of Southern Theater Command (Guangzhou, China) in December, 2025, with a 3-week history of rapidly spreading, painful subcutaneous nodules (figure A), and bilateral knee pain. He was on maintenance oral tegafur after initial response to FOLFIRINOX. His knee pain, initially managed as gout given his history, was unresponsive to treatment. Skin biopsy revealed lobular panniculitis with neutrophilic infiltration and anucleate necrotic adipocytes (ghost cells), consistent with pyogenic panniculitis (figure B).