PMC8077481_01
Treatment timeline.
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F1
Evolution of the metastatic periumbilical nodules of pancreatic adenocarcinoma throughout the Gemzar  treatment. A Fourth cycle of Gemzar , started on February 12, 2020. B Fifth cycle of Gemzar , started on March 4, 2020. C Sixth cycle of Gemzar , started on March 25, 2020.
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F2
However, during the fourth cycle of gemcitabine (Gemzar ; Eli Lilly), three periumbilical indurated nodules appeared, two of which were erythematous (Fig. 2A). During the fifth cycle of gemcitabine, these nodules remained visible and slightly increased in size (Fig. 2B). The umbilical orifice showed unfolding of the umbilicus (Fig. 2C).
Evolution of the metastatic periumbilical nodules of pancreatic adenocarcinoma throughout the FOLFIRI treatment. A First cycle of FOLFIRI, started on April 15, 2020. B Second cycle of FOLFIRI, started on April 28, 2020. C Third cycle of FOLFIRI, started on May 12, 2020.
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F3
Under FOLFIRI, there was clinical progression of the periumbilical lesions (Fig. 3); in particular, greater induration and subcutaneous infiltration occurred, which were responsible for increased pain.