Impact of platinum complexes on dihydropyrimidine dehydrogenase activity in 5-fluorouracil-treated patients.

to control the severe pain in the left chest wall. The patient received oral administration of 80 mg/day of 1 M tegafur–0.4M 5-chloro-2,4-dihydroxypyridine–1 M potassium oxonate (S-1) for 4 weeks as a final line chemotherapy because of hematological toxicity resulting from the previous chemotherapy. Six weeks later, the lesions dried, diminished remarkably in size and showed scab formation (Figure 1B). The left chest pain disappeared, and the administration of morphine sulfate became unnecessary. She was discharged, and is presently enjoying a normal life. Metastasis to the skin is a comparatively rare complication of internal malignancies [1]. The clinical presentations appear as flesh-colored to red-purple or brownish solitary papules or nodules. Although carcinoma erysipeloides are frequently observed in patients affected by breast carcinoma, they are rarely observed during the course of other malignant tumors. These metastases are the clinical representation of the rapid spread of tumor cells along subepidermal lymphatic vessels. As a consequence of lymphatic blockage, edema, erythema and vesicles can appear [2]. Although both the appearance of tumors from gastric cancer and their successful treatment are very rare, S-1 was an effective anticancer drug in the present case. S-1 is a newly developed oral anticancer drug, which consists of tegafur, gimeracil and oteracil potassium at a molecular ratio of 1:0.4:1, based on the biochemical modulation of 5-FU [3]. S-1 was more effective for lymph node metastasis than for the primary lesion, lung metastasis or liver metastasis in a phase II study [4]. Moreover, this oral anticancer drug has the advantage of not requiring hospitalization for patients with good performance status, because of its mild toxicity. The prognosis of gastric cancer with skin metastasis is generally poor, thus treatment preserving the quality of life of cancer patients should be considered positively.