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He FJ, Zhang P, Wang MJ, Chen Y, Zhuang W. Left armpit subcutaneous metastasis of gastric cancer: A case report. World J Clin Cases 2019; 7:4137-4143. [PMID: 31832419 PMCID: PMC6906569 DOI: 10.12998/wjcc.v7.i23.4137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/01/2019] [Accepted: 11/13/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Gastric cancer is the third most lethal malignant tumor worldwide. Metastasis has always been a major cause of poor prognosis. Epidemiological evidence shows that the most common sites for metastasis of gastric carcinoma are the liver (48%), peritoneum (32%), lung (15%), and bone (12%); however, subcutaneous metastasis is are and occurs in approximately 0.8% of cases. We report a rare case of armpit subcutaneous metastasis of gastric cancer. The best surgical window was missed, as a result of lacking attention of the mass.
CASE SUMMARY A 69-year-old man who had previously undergone radical gastrectomy and received eight cycles of oral chemotherapy for gastric cancer showed a rapidly growing mass in his the left armpit; within just 3 mo, the mass grew to a size of 6.9 cm × 4.4 cm × 5.7 cm. Color Doppler ultrasonography and Positron emission tomography/computed tomography prompted the possibility of metastasis of the malignancy. Fine needle aspiration biopsy guided by color Doppler ultrasound showed the presence of cancer cells in the mass. Immunohistochemical examination showed CDX-2 (+), PCK (+), CK20 (+), CK7 (-), and TTF (-), which supported the metastasis of gastric cancer. Considering the risk of resection, the patient did not undergo surgical treatment.
CONCLUSION The case indicates that unidentified subcutaneous masses in patients with a history of gastric cancer should be carefully evaluated.
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Affiliation(s)
- Feng-Jun He
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Peng Zhang
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Mo-Jin Wang
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi Chen
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wen Zhuang
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
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Abstract
RATIONALE The prognosis of lung cancer is dismal, which has resulted in lung carcinoma being one of the leading causes of cancer-related deaths worldwide. Non-small cell lung cancer accounts for approximately 80% of all types of lung carcinoma. The skeletal system and central nervous system are the most common distal metastatic sites in patients with lung cancer, while cutaneous and soft tissues metastasis is rare. PATIENT CONCERNS We report a case of concomitant metastasis in the nasal tip and suspected buttocks metastasis secondary to lung cancer, who complained of repeated cough and white sputum for 6 months. DIAGNOSE Primary lung cancer was diagnosed by bronchoscopy and biopsy, lesion on nasal tip was confirmed by biopsy. Furthermore, PET-CT scan identified the untouchable buttocks lesion that could have been easily missed. INTERVENTIONS This patient refused systemic treatments, but he chose traditional Chinese medicine at home. OUTCOMES He died 6 months after the diagnosis. LESSONS The possibility of metastasis of primary cancers should be considered when encountering soft-tissue neoplasm lesions, and a biopsy of the suspicious cutaneous lesions could likely aid in the histological identification of the primary cancer. PET-CT scan could be an effective supplementary tool for the diagnosis and evaluation of cancers.
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Affiliation(s)
| | - Jialu Chen
- Department of Gynaecology, Women's & Children's Hospital of Haining city
| | - Fanfan Yang
- Department of Pathology, People's Hospital of Haining city, Haining, Zhejiang province, China
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53
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Ruiz SJ, Al Salihi S, Prieto VG, Nagarajan P, Tetzlaff MT, Curry JL, Ivan D, Torres-Cabala CA, Aung PP. Unusual cutaneous metastatic carcinoma. Ann Diagn Pathol 2019; 43:151399. [PMID: 31675677 DOI: 10.1016/j.anndiagpath.2019.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/11/2019] [Indexed: 02/08/2023]
Abstract
Most of metastatic tumors to the skin are from primary tumors of the breast, lung, or from melanoma; metastases to the skin from primary carcinomas at other sites are rare. Cutaneous metastases of visceral carcinomas most often occur in patients with advanced disease, and are associated with a poor prognosis. We report 6 cases of nonmammary, nonpulmonary carcinoma metastatic to the skin. Most patients were elderly with advanced disease at the time of diagnosis of skin metastasis. The primary tumor sites included the thyroid, esophagus, biliary tract, ovary, and prostate. Awareness of these rare cases of metastasis to the skin will help pathologists and clinicians make the correct diagnosis.
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Affiliation(s)
- Sory J Ruiz
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Suhair Al Salihi
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Victor G Prieto
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Priyadharsini Nagarajan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael T Tetzlaff
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jonathan L Curry
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Doina Ivan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos A Torres-Cabala
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Phyu P Aung
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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54
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Sakanaka K, Ishida Y, Mizowaki T. A Case Report of Locally Advanced Anal Cancer with Solitary Cutaneous Nodular Metastasis in the Ipsilateral Labia Majora Treated with Definitive Chemoradiotherapy. Case Rep Oncol 2019; 12:721-727. [PMID: 31607890 PMCID: PMC6787419 DOI: 10.1159/000503171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 11/19/2022] Open
Abstract
Cutaneous metastasis from anal cancer is rare at the initial diagnosis. There is a dearth of information on definitive treatment for anal cancer with cutaneous metastasis. We report the case of a 63-year-old female with locally advanced anal cancer and solitary cutaneous nodular metastasis in the right labia majora identified at the initial diagnosis that was successfully treated with definitive chemoradiotherapy. She arrived at our hospital with complaints of an enlarging perineal itching nodule. Genital and rectal examination detected an anal tumor with perineal and rectal invasion. The biopsy specimen indicated it was a squamous cell carcinoma that was accompanied by right inguinal and external iliac lymph nodal metastases and solitary cutaneous nodular metastasis in the ipsilateral labia majora. She was diagnosed with anal cancer, clinical T3N1M1, stage IV (UICC-TNM 7th). She had good performance status and effective organ function. She received definitive chemoradiotherapy with irradiation fields that included the primary tumor, pelvic lymph nodal metastases, and solitary cutaneous genital metastasis. After completing the planned treatment, all tumors vanished without recurrences at 42 months after treatment. In conclusion, patients with locally advanced anal cancer may suffer genital cutaneous metastasis that develops with lymphatic drainage from the anus to the inguinal lymph nodes. Anal cancer with solitary genital cutaneous nodular metastasis can be considered as a local-regional disease and can be treated with chemoradiotherapy. Chemoradiotherapy achieved a cure in our case.
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Affiliation(s)
- Katsuyuki Sakanaka
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuichi Ishida
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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55
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Spooner J, Birk M, Salina D, Hoag N. Images - A nose metastasis heralding renal cell carcinoma recurrence 25 years post-nephrectomy. Can Urol Assoc J 2019; 14:E111-E112. [PMID: 31599715 DOI: 10.5489/cuaj.5905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jesse Spooner
- University of British Columbia Faculty of Medicine, Vancouver, BC, Canada
| | - Manjot Birk
- University of British Columbia Faculty of Medicine, Vancouver, BC, Canada
| | - Davide Salina
- University of British Columbia, Department of Pathology, Victoria, BC, Canada
| | - Nathan Hoag
- University of British Columbia, Department of Urologic Sciences, Victoria, BC, Canada
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56
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Fukuda Y, Mikuni H, Homma T, Sagara H. Cutaneous metastases of lung cancer. Clin Case Rep 2019; 7:1796-1797. [PMID: 31534754 PMCID: PMC6745358 DOI: 10.1002/ccr3.2331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 06/05/2019] [Accepted: 07/05/2019] [Indexed: 11/30/2022] Open
Abstract
Cutaneous metastases of lung cancer are rare. It was often painless and less likely to be noticed. Similar to SVC syndrome, cutaneous metastases may cause upper limb edema. We need to keep in mind that cutaneous metastases may account for the radiotherapy-resistant upper limb edema.
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Affiliation(s)
- Yosuke Fukuda
- Department of Medicine, Division of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
| | - Hatsuko Mikuni
- Department of Medicine, Division of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
| | - Tetsuya Homma
- Department of Medicine, Division of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
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57
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Gupta N, Malik D, Verma R, Belho ES, Manocha A. Cutaneous Metastasis from Visceral Organs: 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography Scan Aiding in Localizing Primary Site. Indian J Nucl Med 2019; 34:205-208. [PMID: 31293299 PMCID: PMC6593935 DOI: 10.4103/ijnm.ijnm_66_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Skin metastases are rare from systemic malignancy, and incidence reported is between 0.7% and 9% in various malignancies and usually occur in advanced stage. Here, we report three cases, one each of carcinoma esophagus, carcinoma breast, and carcinoma lung, where patients presented with metastatic cutaneous lesions and positron-emission tomography-computed tomography (PET-CT) scan whole body helped in localizing the primary site. Whole-body fluorodeoxyglucose PET-CT scan helps in scanning whole body at once and detect occult primary and metastatic sites.
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Affiliation(s)
- Nitin Gupta
- Department of Nuclear Medicine and PET/CT, Centre for Advanced Research in Imaging, Neuroscience and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Dharmender Malik
- Department of Nuclear Medicine and PET/CT, Centre for Advanced Research in Imaging, Neuroscience and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Ritu Verma
- Department of Nuclear Medicine and PET/CT, Centre for Advanced Research in Imaging, Neuroscience and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Ethel Shangne Belho
- Department of Nuclear Medicine and PET/CT, Centre for Advanced Research in Imaging, Neuroscience and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Anisha Manocha
- Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India
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58
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Abstract
Cutaneous metastasis portends a poor prognosis. Therefore, a high clinical index of suspicion is necessary so that a clinician knows how to recognize the presentation of a cutaneous metastasis, while the pathologist must know the appropriate stains to order. In this review, the authors summarize the common and uncommon ways that these tumors will present. Frequently a metastatic cancer will present as a firm red nodule or as a plaque, ulcer, or papule. Less commonly they will present with a clinical clue that can alert a clinician to a likely diagnosis; these manifestations include alopecic, vesicular, blue color, sclerodermoid, acrochordon-, or pellagra-like.
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Affiliation(s)
- Evan Alexander Choate
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alexander Nobori
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Scott Worswick
- Department of Dermatology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Ezralow Tower, Suite 5301, Los Angeles, CA 90033-9174, USA.
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59
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Otsuka I. Cutaneous Metastasis after Surgery, Injury, Lymphadenopathy, and Peritonitis: Possible Mechanisms. Int J Mol Sci 2019; 20:E3286. [PMID: 31277406 PMCID: PMC6651228 DOI: 10.3390/ijms20133286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/27/2019] [Accepted: 07/01/2019] [Indexed: 12/12/2022] Open
Abstract
Cutaneous metastases from internal malignancies are uncommon. Umbilical metastasis, also known as Sister Joseph nodule (SJN), develops in patients with carcinomatous peritonitis or superficial lymphadenopathy, while non-SJN skin metastases develop after surgery, injury, and lymphadenopathy. In this review, the possible mechanisms of skin metastases are discussed. SJNs develop by the contiguous or lymphatic spread of tumor cells. After surgery and injury, tumor cells spread by direct implantation or hematogenous metastasis, and after lymphadenopathy, they spread by extranodal extension. The inflammatory response occurring during wound healing is exploited by tumor cells and facilitates tumor growth. Macrophages are crucial drivers of tumor-promoting inflammation, which is a source of survival, growth and angiogenic factors. Angiogenesis is promoted by the vascular endothelial growth factor (VEGF), which also mediates tumor-associated immunodeficiency. In the subcutaneous tissues that surround metastatic lymph nodes, adipocytes promote tumor growth. In the elderly, age-associated immunosuppression may facilitate hematogenous metastasis. Anti-VEGF therapy affects recurrence patterns but at the same time, may increase the risk of skin metastases. Immune suppression associated with inflammation may play a key role in skin metastasis development. Thus, immune therapies, including immune checkpoint inhibitors reactivating cytotoxic T-cell function and inhibiting tumor-associated macrophage function, appear promising.
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Affiliation(s)
- Isao Otsuka
- Department of Obstetrics and Gynecology, Kameda Medical Center, Kamogawa 296-8602, Japan.
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60
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Kostopoulos N, Platsidaki E, Tzanetakou V, Petraki K, Lekarakou M, Bafaloukos D, Potouridou I. Nodular Lesions on the Upper Trunk: An Uncommon Anatomical Site of Renal Tumor Metastases. Indian J Dermatol 2019; 64:251. [PMID: 31148873 PMCID: PMC6537680 DOI: 10.4103/ijd.ijd_634_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Renal cell carcinoma (RCC) is the most frequent cancer of the kidney and it accounts for 3% of all solid malignancies. Although rare, cutaneous metastases can be an important manifestation of RCC. We present a case of a 56-year-old male with a history of RCC, followed by the development of cutaneous metastases 4 years later with an uncommon clinical presentation. RCC is the most common genitourinary cancer to metastasize to the skin and accounts for 6.8% of cutaneous metastases. These patients have a poor prognosis. It is essential for these patients to perform a complete periodic dermatologic examination for proper restaging and treatment.
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Affiliation(s)
| | | | | | | | - Maria Lekarakou
- Department of Pathology, Metropolitan Hospital, Piraeus, Greece
| | | | - Irini Potouridou
- Department of Dermatology, Andreas Syggros Hospital, Athens, Greece
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61
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Jia QN, Jin HZ, Zeng YP. An Elderly Woman With Violaceous Swelling With Telangiectasia and Necrosis on the Face. JAMA Dermatol 2019; 155:615-616. [PMID: 30916711 DOI: 10.1001/jamadermatol.2018.5316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Qian-Nan Jia
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong-Zhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-Ping Zeng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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62
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Rajeshwari M, Sakthivel P, Sikka K, Jain D. 'Carcinoma en cuirasse' in the neck: extremely unusual initial presentation of gastric cancer. BMJ Case Rep 2019; 12:12/4/e228418. [PMID: 31040139 DOI: 10.1136/bcr-2018-228418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Cutaneous metastasis from visceral malignancy is a relatively rare phenomenon. It is even rarer to have cutaneous lesions as the first mode of clinical presentation in such malignancies. The lesions are usually nodular, although they can have varied appearances. Common sites of primaries include breast, lung, colorectum, kidney, ovary, and headandneck. We report an unusual form of cutaneous metastasis in the neck, known as 'carcinoma en cuirasse', in an elderly man that subsequently led to the diagnosis of an occult gastric cancer. Our case highlights the importance of recognising cutaneous metastatic lesions early, as they may herald the diagnosis of an occult internal malignancy.
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Affiliation(s)
- Madhu Rajeshwari
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Pirabu Sakthivel
- Department of ENT and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Sikka
- Department of ENT and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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63
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Kwa MC, Dulmage BO, Shastry JL, Yazdan P, Choi JN. Rare presentation of cutaneous lung cancer metastasis presenting as carcinoma erysipeloides. JAAD Case Rep 2019; 5:332-335. [PMID: 30993159 PMCID: PMC6449738 DOI: 10.1016/j.jdcr.2019.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | | | | | - Jennifer N. Choi
- Correspondence to: Jennifer N. Choi, MD, Northwestern University Feinberg School of Medicine, Department of Dermatology, Suite 1600, 676 N. St. Clair St, Chicago, IL 60611.
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64
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Large single cutaneous metastasis of colon adenocarcinoma mimicking a squamous cell carcinoma of the skin: A case report. Int J Surg Case Rep 2019; 56:96-100. [PMID: 30870738 PMCID: PMC6424055 DOI: 10.1016/j.ijscr.2019.02.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 01/30/2019] [Accepted: 02/25/2019] [Indexed: 12/19/2022] Open
Abstract
Skin Cancer. Colorectal Cancer. Cutaneous Metastases. Fasciocutaneous Flaps.
Introduction Metastases represent one of the most outstanding characteristics of malignant neoplasms and are relatively rare in the skin, in spite of the great extension of the cutaneous organs. Development of cutaneous metastases from colon cancer is a rare event, usually occurring in widely disseminated disease and commonly leading to a poor prognosis. As to location, cutaneous metastases often favor areas close to the primary malignancy, such as lung cancer and skin metastases on the trunk. However, remote sites as the scalp may be also involved. Case presentation We present the case of a 92-year-old female patient with a massive single nodular skin lesion on her left supraclavicular area, that came back positive for cutaneous metastasis of colon adenocarcinoma. Discussion Cutaneous metastasis of colorectal cancer a rare event (2.3%–6%) that usually occur two years after the detection or resection of the primary tumor. It seldom occurs before the identification of the primary tumor and involvement of secondary organs, such as the liver. There are few cases reported with only cutaneous metastases. Conclusion In conclusion, dermatological evaluation of patients who are undergoing screening or who have already been diagnosed with cancer is extremely important.
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65
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Epidermotropic poorly differentiated adenocarcinoma of colon presenting as a diffuse erythematous petechial rash. JAAD Case Rep 2019; 5:113-115. [PMID: 30671523 PMCID: PMC6330357 DOI: 10.1016/j.jdcr.2018.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Habermehl G, Ko J. Cutaneous Metastases: A Review and Diagnostic Approach to Tumors of Unknown Origin. Arch Pathol Lab Med 2018; 143:943-957. [PMID: 30605024 DOI: 10.5858/arpa.2018-0051-ra] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Cutaneous metastases from a distant malignancy are a diagnostic challenge for pathologists. Secondary involvement of the skin by a metastatic process portends a much worse clinical prognosis than any primary cutaneous malignant mimickers. Immunohistochemical staining methods continue to evolve and are of paramount importance in diagnosis. OBJECTIVE.— To review the clinical, histopathologic, and immunohistochemical staining patterns for commonly encountered entities and discuss potential pitfalls in diagnosis. A practical guide useful in approaching cutaneous metastases of unknown primary is outlined. DATA SOURCES.— An extensive search and review of literature in PubMed was performed, processed, and condensed. CONCLUSIONS.— Cutaneous metastases have broad histopathologic patterns. They are nearly always dermal based, with an overall foreign appearance. They can be single papules/nodules or multiple in number, mimicking an inflammatory or infectious process. Ultimately, immunohistochemistry remains an essential diagnostic tool, and clinical correlation is paramount in the workup of these entities.
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Affiliation(s)
- Gabriel Habermehl
- From the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jennifer Ko
- From the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
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67
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Wichtowski M, Murawa D, Czarnecki R, Piechocki J, Nowecki Z, Witkiewicz W. Electrochemotherapy in the Treatment of Breast Cancer Metastasis to the Skin and Subcutaneous Tissue - Multicenter Experience. Oncol Res Treat 2018; 42:47-51. [PMID: 30537762 DOI: 10.1159/000494093] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 09/17/2018] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Breast cancer is responsible for more than 50% of cutaneous metastases. One of the treatment options is electrochemotherapy (ECT). It is an effective method of local tumor ablation through the application of electroporation. The primary objective of the study was to demonstrate a response to the treatment in our group of patients. METHODS Between February 2015 and October 2016, in 3 centers in Poland, 47 ECT procedures were performed in 38 patients with metastasis of breast cancer to the skin. RESULTS At 12 weeks after the procedures, 71% of patients showed a positive response to the treatment (42% with complete response, and 29% with partial response). Multivariate analysis demonstrated that only the estrogen receptor status and the size of the metastatic lesion were predictive of overall response (p = 0.0243 and p = 0.03716, respectively). CONCLUSION The results of our study demonstrate a high effectiveness of ECT in the treatment of cutaneous metastasis from breast cancer. This method, although used for palliative treatment, brings a significant improvement in the quality of life of patients.
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68
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Gupta B, Mallya V, Jain S, Agarwal PN. Utility of FNAC in Dermatological Manifestations of Metastatic Cancer with the Review of the Literature. J Cytol 2018; 35:237-241. [PMID: 30498297 PMCID: PMC6210811 DOI: 10.4103/joc.joc_158_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives Cutaneous metastasis (CM) though rare, indicates a terminal event in any malignancy and has a grave outcome. The present study reiterates the role of fine needle aspiration cytology (FNAC) in the diagnosis of metastatic cutaneous nodules. Materials and Methods From 2015 to 2017, the department received 22,000 cases for FNAC. Among these cases, aspirations from the skin and subcutaneous region were performed on 6,083 cases. After excluding primary tumors of skin/subcutis, 25 cases on cytology were suggestive of metastasis. Clinicoradiological and histopathological profiles in these cases were reviewed. Results Among these 25 patients, the male to female ratio was 1:1.09 (F, 12; M, 13) in the age group of 18-72 years. Most common primary malignancy in females was of breast and in males was gall bladder. The most common manifestation was a palpable skin nodule, with the abdominal wall being the predominant site. The most common diagnosis, on cytology, was metastatic adenocarcinoma. Conclusion FNAC is a minimally invasive method, which aides in prompt detection and appropriate management of cases presenting with skin nodules and clinically unsuspected of malignancy. Whereas in known primary tumor, it indicates dismal prognosis by diagnosing CM; in cases with unknown primaries, cytomorphology in conjunction with clinicoradiological findings often gives a clue to the possible primary site.
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Affiliation(s)
- Barkha Gupta
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Varuna Mallya
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Shyama Jain
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - P N Agarwal
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
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Vanidassane I, Mittal A, Kumar C, Tanwar P, Sahoo RK, Batra A. Skin metastasis: a rare presentation in testicular germ cell tumour. BMJ Case Rep 2018; 2018:bcr-2018-226385. [PMID: 30249738 DOI: 10.1136/bcr-2018-226385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 35-year-old man presented with a history of cough, haemoptysis, weight loss for 2 months along with ulceroproliferative lesions on the chin and the scalp. On evaluation he was found to have non-seminomatous germ cell tumour, stage 3 c, poor risk with Eastern Cooperative Oncology Group Performance Status of 4. The skin lesions were proven to be metastasis by fine-needle aspiration cytology. He showed significant improvement with a 3-day protocol of abbreviated etoposide and cisplatin chemotherapy and is planned for 4 cycles of VIP. This case describes an uncommon presentation of germ cell tumour in the form of skin metastasis with excellent response to chemotherapy.
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Affiliation(s)
| | - Abhenil Mittal
- Department of Medical Oncology, BRAIRCH, AIIMS, New Delhi, India
| | - Chandan Kumar
- Laboratory Oncology Unit, BRAIRCH, AIIMS, New Delhi, India
| | - Pranay Tanwar
- Laboratory Oncology Unit, BRAIRCH, AIIMS, New Delhi, India
| | | | - Atul Batra
- Department of Medical Oncology, BRAIRCH, AIIMS, New Delhi, India
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70
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Sehrawat A, Kotwal SA, Parthasarathy KM. Metastatic Dermatosis in Breast Carcinoma on Adjuvant Trastuzumab: Is Skin a Sanctuary Site in Human Epidermal Growth Factor Receptor-2-Amplified Disease? Indian J Dermatol 2018; 63:424-426. [PMID: 30210167 PMCID: PMC6124245 DOI: 10.4103/ijd.ijd_234_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cutaneous metastasis (CM) from internal malignancies is commonly seen. Sometimes, skin metastases can be the first sign of advanced cancer or an indicator of cancer recurrence. Cases of breast cancer with cutaneous progression after or during trastuzumab therapy have been described in the past, frequently associated with systemic disease progression. However, CM during adjuvant trastuzumab therapy is very rare. It has been hypothesized that cancer cells located in the skin survive and take proliferative advantage by virtue of an immune-tolerance mechanism that hampers trastuzumab-mediated antibody-dependent cell-mediated cytotoxicity. We describe a case of human epidermal growth factor receptor-2-overexpressing breast cancer presenting with diffuse CM during adjuvant trastuzumab therapy.
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Affiliation(s)
- Amit Sehrawat
- From the Department of Medical Oncology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India
- Address for correspondence: Dr. Amit Sehrawat, Department of Medical Oncology, Dharamshila Narayana Superspeciality Hospital, Vasundhara Enclave, New Delhi - 110 096, India. E-mail:
| | - Sumedha A. Kotwal
- Department of Pathology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India
| | - K. M. Parthasarathy
- From the Department of Medical Oncology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India
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71
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Phelan PS, Mull JL, Rajput MZ, Musiek AC. Concurrent metastases of papillary thyroid carcinoma to the scalp and Meckel's cave. BMJ Case Rep 2018; 2018:bcr-2017-222552. [PMID: 29914897 DOI: 10.1136/bcr-2017-222552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 65-year-old man with severe headaches and unilateral facial weakness, seen in consultation by the dermatology service to rule out primary cutaneous melanoma after brain imaging identified an enlarging mass within the right trigeminal (Meckel's) cave. Examination revealed only a pair of erythematous papules on the scalp, for which biopsy demonstrated metastatic papillary thyroid carcinoma. Further evaluation and subsequent thyroidectomy confirmed the origin of widespread internal disease, followed by definitive excision of scalp lesions and multimodal management of systemic involvement. Whereas presentation of metastasis to the skin is highly variable, a low threshold for biopsy may allow for histological identification of internal disease not otherwise considered in the clinical differential.
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Affiliation(s)
- Patrick S Phelan
- Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
| | - Jamie L Mull
- Division of Dermatology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
| | - Mohamed Z Rajput
- Washington University in Saint Louis School of Medicine, Mallinckrodt Institute of Radiology, Saint Louis, Missouri, USA
| | - Amy C Musiek
- Division of Dermatology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
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72
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Martínez-Morán C, Echeverría-García B, Khedaoui R, Borbujo J. Cutaneous Metastasis in a Patient With Lung Cancer. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2017.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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73
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Torraca PDFS, Castro BCD, Hans G, Lima AMD. Cutaneous metastases in a patient with no previous diagnosis of cancer: diagnostic challenge. An Bras Dermatol 2018; 92:47-49. [PMID: 29267444 PMCID: PMC5726675 DOI: 10.1590/abd1806-4841.20175870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 09/26/2016] [Indexed: 12/26/2022] Open
Abstract
On rare occasions, skin lesions are the first local of metastatic manifestation
of internal malignancies. In case of no previous diagnosis of these tumors, the
approach of suspicious skin lesions becomes a challenge, especially in
differentiating cutaneous metastases and adnexal primary neoplasms. Currently,
besides epidemiologic, dermoscopic and histopathologic aspects, the evaluation
also integrates immunohistochemical exams and cell markers such as p40 and p63,
highly specific for skin metastases. This article describes the case of
cutaneous metastases as the sole obvious sign of breast cancer in a previously
asymptomatic woman. The diagnosis was made by the finding of neoplastic cells in
the dermis and immunohistochemistry compatible with ductal carcinoma.
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Affiliation(s)
- Pedro de Freitas Silva Torraca
- Department of Internal Medicine of the Faculdade de Medicina da Universidade Federal de Mato Grosso do Sul (Famed-UFMS) - Campo Grande (MS), Brazil
| | - Bruna Corrêa de Castro
- Dr. Günter Hans Department of Dermatology, at Hospital Universitário da Universidade Federal de Mato Grosso do Sul (NHU-UFMS) - Campo Grande (MS), Brazil
| | - Günter Hans
- Dr. Günter Hans Department of Dermatology, at Hospital Universitário da Universidade Federal de Mato Grosso do Sul (NHU-UFMS) - Campo Grande (MS), Brazil
| | - Alexandre Moretti de Lima
- Dr. Günter Hans Department of Dermatology, at Hospital Universitário da Universidade Federal de Mato Grosso do Sul (NHU-UFMS) - Campo Grande (MS), Brazil
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74
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Lee JS, Kim WG. Cutaneous metastases of breast cancer during adjuvant chemotherapy correlates with increasing CD44 +/CD24 - and ALDH-1 expression: a case report and literature review. Stem Cell Investig 2018; 5:7. [PMID: 29682514 DOI: 10.21037/sci.2018.03.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/28/2018] [Indexed: 01/16/2023]
Abstract
Cancer stem cells (CSCs) within a tumor are scarce and self-sustaining and they have the abilities for self-renewal and the potential of giving rise to diverse types of cells that compose the tumor. These cells are suggested to be associated with therapeutic failure, and therefore they remain as an important issue in this regard. We report the cases of two breast cancer patients diagnosed with rapid cutaneous metastases during adjuvant cytotoxic chemotherapy after curative mastectomy. For elucidating a relationship between CSCs and resistance to chemotherapy, we evaluated primary tumor and metastatic cutaneous lesions by CSC markers in immunohistochemical stains (CD44+/CD24- and ALDH-1). Either CD44+/CD24- or ALDH-1 expression increased compared to primary breast cancer during chemotherapy. This case report shows that CD44+/CD24- or ALDH-1 expression in primary or cutaneous metastatic breast cancer may be associated with rapid onset chemoresistance.
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Affiliation(s)
- Jung Sun Lee
- Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Woo Gyeong Kim
- Department of Pathology, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
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75
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Wick MR. Primary lesions that may imitate metastatic tumors histologically: A selective review. Semin Diagn Pathol 2018; 35:123-142. [DOI: 10.1053/j.semdp.2017.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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76
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Trivedi V, Abdul khalam M, Ghosh M, Chauhan R, Naseera S. An exceptional case of cutaneous metastasis of squamous cell carcinoma of the lip. JOURNAL OF CANCER RESEARCH AND PRACTICE 2017. [DOI: 10.1016/j.jcrpr.2017.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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77
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Kuo SH, Yu FJ, Shih HY, Kuo HK, Wu CC, Lee PY, Wu IC. Unusual subcutaneous and choroidal metastases from esophageal squamous cell carcinoma denote a poor prognosis: A case report and literature review. ADVANCES IN DIGESTIVE MEDICINE 2017. [DOI: 10.1002/aid2.12144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shin-Huei Kuo
- Department of Internal Medicine; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
| | - Fang-Jung Yu
- Division of Gastroenterology, Department of Internal Medicine; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Medicine, College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Hsiang-Yao Shih
- Division of Gastroenterology, Department of Internal Medicine; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
| | - Hsi-Kung Kuo
- Department of Ophthalmology; Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Kaohsiung Taiwan
| | - Chun-Chieh Wu
- Department of Pathology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
| | - Po-Yen Lee
- Department of Ophthalmology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
| | - I-Chen Wu
- Division of Gastroenterology, Department of Internal Medicine; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Medicine, College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
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78
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Mitrushi A, Bilali S, Bilali V, Mitrushi F, Mehmeti E. A clinical case of perineal invasion from rectal carcinoma. G Chir 2017; 38:199-201. [PMID: 29182902 DOI: 10.11138/gchir/2017.38.4.199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report a case of 62-year old women with skin infiltration in the perineal area after anterior rectal resection due to upper rectal cancer. Computed Tomography (CT) shows an intense infiltrative aspect of the lesion. The patient had a diffuse perineal infiltration predominantly at Levator Ani muscles and adhesions to the posterior parts of urinary bladder, uterus, vagina and perineal skin. The patient underwent surgery with colostomy to relieve the colonic tract due to obstruction and later was treated with chemo-radiation.
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79
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Martínez-Morán C, Echeverría-García B, Khedaoui R, Borbujo J. Cutaneous Metastasis in a Patient With Lung Cancer. ACTAS DERMO-SIFILIOGRAFICAS 2017; 109:372-374. [PMID: 29106840 DOI: 10.1016/j.ad.2017.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/22/2017] [Accepted: 05/14/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- C Martínez-Morán
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, España.
| | - B Echeverría-García
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, España
| | - R Khedaoui
- Servicio de Anatomía Patológica, Hospital Universitario de Fuenlabrada, Madrid, España
| | - J Borbujo
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, España
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80
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Mok ZR, Yong AMY, Leung AJ, Tan KB, Aw DCW. Cutaneous metastasis: experience from a tertiary healthcare institution in Singapore. Int J Dermatol 2017; 56:1497-1498. [PMID: 28833072 DOI: 10.1111/ijd.13650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 04/09/2017] [Accepted: 04/13/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Zhun R Mok
- National University Hospital, Singapore City, Singapore
| | | | - An J Leung
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Kong B Tan
- National University Hospital, Singapore City, Singapore
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81
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Ueda J, Yoshida H, Makino H, Maruyama H, Yokoyama T, Hirakata A, Takata H, Seki N, Kikuchi Y, Uchida E. A case of sigmoid colon adenocarcinoma diagnosed as facial cutaneous metastasis for survival after operation for 37 months. Clin J Gastroenterol 2017; 10:420-425. [PMID: 28776316 DOI: 10.1007/s12328-017-0767-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 07/21/2017] [Indexed: 11/29/2022]
Abstract
Cutaneous metastasis of an internal malignancy is uncommon and is estimated to occur in 0.7-9% of patients with internal cancer including autopsy cases. We would like to report a case of long survival of sigmoid colon adenocarcinoma diagnosed as an instance of facial cutaneous metastasis. A 68-year-old male was admitted to our hospital for a tumor mass on the left side of his cheek. In his past history, acute myocardial infarction had occurred 2 years earlier. He also had chronic renal failure and chronic obstructive pulmonary disease. Histologic findings from the biopsy sample of this facial lesion were moderately differentiated adenocarcinoma. Colonoscopy revealed a tumor 20 mm × 30 mm in diameter in the sigmoid colon. Histologic findings of the biopsy sample of this tumor also indicated moderately differentiated adenocarcinoma. The patient was diagnosed with sigmoid colon cancer with cutaneous metastasis to the face. We performed a sigmoidectomy with lymph node dissection and resection of the facial cutaneous metastasis. After being discharged, low dose chemotherapy was performed in consideration of the patient's renal function. Although long-term management of his general condition was provided, the patient died 37 months after surgery because of chronic heart failure.
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Affiliation(s)
- Junji Ueda
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo, 206-8512, Japan.
| | - Hiroshi Yoshida
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo, 206-8512, Japan
| | - Hiroshi Makino
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo, 206-8512, Japan
| | - Hiroshi Maruyama
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo, 206-8512, Japan
| | - Tadashi Yokoyama
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo, 206-8512, Japan
| | - Atsushi Hirakata
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo, 206-8512, Japan
| | - Hideyuki Takata
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo, 206-8512, Japan
| | - Natsuki Seki
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo, 206-8512, Japan
| | - Yuta Kikuchi
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo, 206-8512, Japan
| | - Eiji Uchida
- Department of Surgery, Nippon Medical School, Tokyo, Japan
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82
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Góes HFDO, Lima CDS, Souza MBD, Estrella RR, Faria MAN, Rochael MC. Single cutaneous metastasis of colon adenocarcinoma - Case report. An Bras Dermatol 2017; 91:517-9. [PMID: 27579752 PMCID: PMC4999115 DOI: 10.1590/abd1806-4841.20164122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 01/05/2015] [Indexed: 12/01/2022] Open
Abstract
Skin metastases are relatively rare and occur most often when the cancer is
already advanced, invading other organs. As to location, they often seem to
elect areas located close to the primary tumor, although distant sites, such as
the scalp, may be affected with some frequency. We present a case of a
76-year-old woman with colon adenocarcinoma that had a single metastatic lesion
on the scalp.
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83
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Karas L, Vangipuram R, Zahiruddin S, Sharghi KG, Peranteau AJ, Tyring SK. A Bumpy Course: Nodules Along a Mastectomy Scar. Am J Med 2017; 130:539-541. [PMID: 28159604 DOI: 10.1016/j.amjmed.2017.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | | | | | - Stephen K Tyring
- Center for Clinical Studies, Houston, Tex; University of Texas Health Science Center at Houston.
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84
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Song YW, Kim WS, Yun GY, Park SW, Kang SH, Moon HS, Sung JK, Jeong HY. [A Case of Early Gastric Cancer with Nodular Tumor-like Scalp Metastasis]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2017; 68:36-9. [PMID: 27443622 DOI: 10.4166/kjg.2016.68.1.36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Many neoplasms, including lung cancer, breast cancer, melanoma, and gastrointestinal tract malignancy, possess potential for skin metastasis. Skin metastases can represent the first presentation of such malignancies and may be observed incidentally during routine exam. Skin metastases from gastric adenocarcinoma are uncommon, with a prevalence rate of 0.04-0.8%. Cutaneous metastases from gastric cancer are generally observed as the initial symptom of advanced gastric cancer. Early detection and treatment can increase patient survival. A 42-year-old woman visited our department with nodule about 1 cm in size on the right frontal scalp noticed incidentally after laparoscopy-assisted distal gastrectomy and adjuvant systemic chemo-therapy for early gastric cancer about 16 months prior. The patient was diagnosed with skin metastasis from gastric adenocarcinoma. Complete excision of the skin lesion and additional chemotherapy were performed. Herein, we report a case of nodular tumor-like scalp metastasis from early gastric cancer with a brief review of the literature.
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Affiliation(s)
- Young Wook Song
- Division of Gastroenterology, Daejeon Veterans Hospital, Daejeon, Korea
| | - Woo Sub Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Gee Young Yun
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sun Wook Park
- Division of Gastroenterology, Daejeon Veterans Hospital, Daejeon, Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hyun Yong Jeong
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
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85
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Damaskos C, Dimitroulis D, Pergialiotis V, Doula C, Koulermou G, Antoniou EA, Frangoulis M, Stergios K, Kontzoglou K. An unexpected metastasis of breast cancer mimicking wheal rush. G Chir 2017; 37:136-138. [PMID: 27734799 DOI: 10.11138/gchir/2016.37.3.136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Breast cancer is the most common cancer among women and ranks second in cancer deaths worldwide. Breast cancer can metastasize to the skin but rarely, cutaneous metastases may be the first indication of the cancer. Skin metastases of breast cancer are usually found on the chest and close to the point of the mastectomy. We present the rare clinical entity of a breast cancer which was first diagnosed due to the skin metastasis away from the breast tumor. This is a rare case because the skin lesions usually appear simultaneously or secondary. Also, while the existing metastasis; the only symptom was the wheal rash.
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86
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Wang F, Tong ZH. Cutaneous Metastasis as the First Symptom: An Uncommon Presentation of Squamous Cell Lung Cancer. Chin Med J (Engl) 2017; 130:115-116. [PMID: 28051036 PMCID: PMC5221103 DOI: 10.4103/0366-6999.196584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Feng Wang
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing 100020, China
| | - Zhao-Hui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing 100020, China
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87
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Namikawa T, Munekage E, Munekage M, Maeda H, Yatabe T, Kitagawa H, Kobayashi M, Hanazaki K. Subcutaneous metastasis arising from gastric cancer: A case report. Mol Clin Oncol 2017; 6:515-516. [PMID: 28413658 DOI: 10.3892/mco.2017.1175] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 01/10/2017] [Indexed: 12/22/2022] Open
Abstract
A 59-year-old man was referred to the Kochi Medical School Hospital due to left shoulder pain. Physical examination revealed a nodular, painful mass lesion in the subcutaneous tissue of the right chest wall, with a diameter of ~2 cm. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower gastric body near the lesser curvature, and biopsy specimens of the gastric and humeral lesions revealed poorly differentiated adenocarcinoma. Abdominal computed tomography revealed multiple low-density lesions in the liver and a well-defined, 2.2-cm mass in the subcutaneous tissue of the right chest wall. The diagnosis was advanced gastric cancer with metastases to the liver, bone and skin, and systemic chemotherapy with radiotherapy for the bone metastasis was recommended. The patient also underwent distal gastrectomy to control bleeding from the primary gastric cancer lesion due to unresolved anemia, not improving by blood transfusion, and a low hemoglobin level. The subcutaneous tumor in the right chest wall was resected at the same time, to alleviate the pain caused by the mass. Macroscopic examination of the resected specimen revealed a well-circumscribed, solid tumor, measuring 2.2×2.1 cm, with a firm consistency. Microscopic examination showed infiltration of poorly differentiated adenocarcinoma cells into the subcutaneous tissue. Subcutaneous metastasis from gastric cancer is a rare manifestation, with a reported incidence of 0.8-1.0%. Cutaneous metastasis of cancer generally appears late in the course of the disease. Surgical resection of metastatic skin tumors is occasionally undertaken as palliative treatment to improve the patient's quality of life by controlling severe symptoms, including pain and hemorrhage.
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Affiliation(s)
- Tsutomu Namikawa
- Department of Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Eri Munekage
- Department of Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Masaya Munekage
- Department of Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Hiromichi Maeda
- Cancer Treatment Center, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Tomoaki Yatabe
- Department of Anesthesiology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Hiroyuki Kitagawa
- Department of Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Michiya Kobayashi
- Cancer Treatment Center, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.,Department of Human Health and Medical Sciences, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Kazuhiro Hanazaki
- Department of Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
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88
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Ha JY, Oh EH, Jung MK, Park SE, Kim JT, Hwang IG. Choroidal and skin metastases from colorectal cancer. World J Gastroenterol 2016; 22:9650-9653. [PMID: 27920486 PMCID: PMC5116609 DOI: 10.3748/wjg.v22.i43.9650] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/17/2016] [Accepted: 08/30/2016] [Indexed: 02/06/2023] Open
Abstract
Choroidal and skin metastasis of colon cancer is rare. In women, the frequency of cutaneous metastasis from colon cancer as the primary lesion in is 9% and skin metastasis occurs in 0.81% of all colorectal cancers. We report a patient with colonic adenocarcinoma who presented with visual disorder in her right eye and scalp pain as her initial symptoms. Contrast-enhance orbital magnetic resonance imaging with fat suppression revealed an infrabulbar mass, and skin biopsy of the posterior parietal scalp confirmed adenocarcinoma. These symptoms were diagnosed as being caused by choroidal and skin metastases of colonic adenocarcinoma. We started palliative chemotherapy with oral capecitabine (1000 mg/m2, twice a day, on days 1-14) every 3 wk, which was effective at shrinking the brain masses and improving the visual disorder. This is the first report that capecitabine is effective at reducing a choroidal and cutaneous metastatic lesion from right-sided colorectal cancer.
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89
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Abstract
The aim of this study is to present 2 rare cases of cutaneous metastases originated from adenocarcinoma of the gastro-esophageal junction, thus, underline the need for early diagnosis and possible treatment of suspicious skin lesions among patients with esophageal malignancy. Metastatic cancer to the skin originated from internal malignancies, mostly lung cancer, breast cancer, and colorectal cancer, constitute 0.5 to 9% of all metastatic cancers. (5, 8, 15) Skin metastases, mainly from squamous cell carcinomas of the esophagus, are rarely reported. Cutaneous metastasis is a finding indicating progressiveness of the disease. (17) More precisely, median survival is estimated approximately 4.7 months. (2, 14) This study is a retrospective review of 2 cases of patients with adenocarcinoma of the esophagus and a review of the literature. Two patients aged 60 and 32 years old, respectively, underwent esophagectomy. Both pathologic reports disclosed adenocarcinoma of the gastro-esophageal junction staged T3 N2 M0 (stage IIIB). During follow-up time, the 2 patients were diagnosed with cutaneous metastases originated from the primary esophageal tumor 11 and 4 months after surgery, respectively. The first patient is alive 37 months after diagnosis, while the second one died 16 months after surgery. Cutaneous metastasis caused by esophageal adenocarcinoma is possible. Therefore, follow-up of patients who were diagnosed with esophageal malignancy and underwent esophagectomy is mandatory in order to reveal early surgical stages.
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90
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Wichtowski M, Potocki P, Kufel-Grabowska J, Streb J, Murawa D. Electrochemotherapy in the Treatment of Massive, Multisite Breast Cancer Metastasis to the Skin and Subcutaneous Tissue: A Case Report. Breast Care (Basel) 2016; 11:353-355. [PMID: 27920629 DOI: 10.1159/000450869] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Chest wall recurrence (CWR) from breast cancer after mastectomy is a difficult to treat disease. Electrochemotherapy (ECT) provides a safe, efficient, and non-invasive locoregional treatment approach in this setting. CASE REPORT A 61-year-old woman presented with unresectable breast cancer recurrence to the skin and subcutaneous tissue for which numerous lines of treatment were unsuccessful. Between February 2015 and May 2015, the patient underwent 3 courses of ECT after which a spectacular regression of the cutaneous metastatic foci was observed. After an overall observation period of 12 weeks, complete clinical remission was achieved. CONCLUSION ECT can be proposed as an effective and safe locoregional therapy for breast cancer CWR and provides an alternative treatment modality to conventional therapies, especially in the case of multiple cutaneous and subcutaneous lesions.
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Affiliation(s)
- Mateusz Wichtowski
- Oncological and General Surgery Ward I, the Greater Poland Cancer Center, Poznan, Poland, Poznan, Poland
| | - Paweł Potocki
- Oncology Department, University Hospital, Śniadeckich 10, Kraków, Poland, Poznan, Poland
| | | | - Joanna Streb
- Oncology Department, University Hospital, Śniadeckich 10, Kraków, Poland, Poznan, Poland
| | - Dawid Murawa
- Oncological and General Surgery Ward I, the Greater Poland Cancer Center, Poznan, Poland, Poznan, Poland; Provincial Specialist Hospital in Wrocław, Research and Development Center, Wrocław, Poland, Poznan, Poland
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91
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Rodríguez-Lojo R, Castiñeiras I, Rey-Sanjurjo J, Fernández-Díaz M. Distant Cutaneous Metastases of Prostate Cancer: A Report of 2 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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92
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Xu X, Lin M, Wang S, Jin Z, Han S, Liu X, Gao Y. Lung Sarcomatoid Carcinoma Metastasis to Skin: A Case Report and Review of the Literature. Cancer Invest 2016; 34:286-92. [PMID: 27348718 DOI: 10.1080/07357907.2016.1193744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sarcomatoid carcinoma is a biphasic neoplasm composed of highly complex, intimately admixed malignant epithelial and mesenchymal elements. We herein report a rare case of cutaneous metastasis of pulmonary sarcomatoid carcinoma that contains liposarcomatous, rhabdosarcomatous and chondrosarcomatous heterologous differentiation, and review relevant literatures to lead to a better understanding of this rare but highly aggressive tumor.
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Affiliation(s)
- Xuezhu Xu
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
| | - Mao Lin
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
| | - Shengyi Wang
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
| | - Zeyu Jin
- b The Clinical Medical College, Shanghai Jiao Tong University , Shanghai , China
| | - Shixin Han
- c Department of Dermatology , First Affiliated Hospital of Dalian Medical University , Dalian , China
| | - Xia Liu
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
| | - Yuxue Gao
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
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93
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Liu IT, Yen CJ. Ampullary carcinoma with cutaneous metastasis. JOURNAL OF CANCER RESEARCH AND PRACTICE 2016. [DOI: 10.1016/j.jcrpr.2015.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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94
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Sala ACB, Vane VM, Scuro ES, Pinto CAL, Aprahamian I. Erysipeloid Carcinoma As the Primary Clinical Presentation of a Pulmonary Adenocarcinoma. J Am Geriatr Soc 2016; 64:1130-2. [PMID: 27225363 DOI: 10.1111/jgs.14096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ana Carolina B Sala
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | | | | | | | - Ivan Aprahamian
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
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95
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Distant Cutaneous Metastases of Prostate Cancer: A Report of 2 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:e52-6. [PMID: 27085465 DOI: 10.1016/j.ad.2015.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 09/16/2015] [Accepted: 09/21/2015] [Indexed: 11/24/2022] Open
Abstract
Cutaneous metastases of prostate cancer are extremely rare. We present 2 cases of distant cutaneous metastases at atypical locations of prostate adenocarcinoma, and highlight the value of 2 immunohistochemical stains-prostatic acid phosphatase and prostate-specific membrane antigen-that can aid diagnosis, particularly in cases with negative staining for prostate-specific antigen.
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96
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Chua S, Li J. Seek and You shall Find. Australas J Dermatol 2016; 57:77-8. [DOI: 10.1111/ajd.12296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Jing Li
- Department of Rheumatology; Jiangsu University Affiliated Hospital; Zhenjiang China
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97
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Schulman JM, Pauli ML, Neuhaus IM, Sanchez Rodriguez R, Taravati K, Shin US, McCalmont TH, Rosenblum MD. The distribution of cutaneous metastases correlates with local immunologic milieu. J Am Acad Dermatol 2016; 74:470-6. [PMID: 26778012 DOI: 10.1016/j.jaad.2015.10.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/20/2015] [Accepted: 10/21/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Metastases to the skin are found with increased frequency at certain sites, such as the scalp, but the biological factors that influence this distribution are not understood. OBJECTIVE We aimed to compare the proportional frequency of metastases at various cutaneous locations with the immunologic microenvironments at those sites. METHODS We retrospectively identified all biopsy specimens of cutaneous metastases diagnosed at our institution from 1991 to 2014 (n = 1984) and mapped their anatomic distribution while controlling for regional surface area. Using a separate, mapped cohort of normal-appearing skin samples (n = 140), we measured the density of regulatory T cells, CD4(+) effector T cells, and CD8(+) T cells by flow cytometry. RESULTS Per unit surface area, cutaneous metastases arise most commonly on the head and neck, followed by the trunk, upper extremities, and lower extremities, respectively. Sites with more frequent metastases tend to contain a greater density of regulatory T cells and a lower proportion of CD8(+) T cells (P < .05). LIMITATIONS Immunologic factors were only assessed in control tissue and were not measured from patients with metastatic disease in this correlative single-center study. CONCLUSION The distribution of cutaneous metastases follows the distribution of regulatory and effector T cells in skin. Further studies are required to prove a mechanistic association between local immunologic factors and the development of cutaneous metastases.
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Affiliation(s)
- Joshua M Schulman
- Department of Dermatology, University of California, San Francisco, California; Department of Pathology, University of California, San Francisco, California
| | - Mariela L Pauli
- Department of Dermatology, University of California, San Francisco, California
| | - Isaac M Neuhaus
- Department of Dermatology, University of California, San Francisco, California
| | | | - Keyon Taravati
- Department of Dermatology, University of California, San Francisco, California
| | - Uk Sok Shin
- Department of Dermatology, University of California, San Francisco, California
| | - Timothy H McCalmont
- Department of Dermatology, University of California, San Francisco, California; Department of Pathology, University of California, San Francisco, California
| | - Michael D Rosenblum
- Department of Dermatology, University of California, San Francisco, California.
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98
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Kaur S, Aggarwal P, Dayal S, Sangwan A, Jain VK, Jindal N. Cutaneous Metastasis from Signet-ring Gastric Adenocarcinoma in a Carcinoma En Cuirasse Pattern: An Unusual Clinical-diagnostic Sequence. Indian J Dermatol 2015; 60:637. [PMID: 26677305 PMCID: PMC4681231 DOI: 10.4103/0019-5154.169162] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Cutaneous metastasis (CM) of gastric adenocarcinoma (ADC) is rare and usually presents late in the course of the disease. We report a rare case of carcinoma en cuirasse (CEC) pattern of CM secondary to gastric malignancy in a 55-year-old male patient—the interesting part being that CM was the first-presenting sign, which on further histopathological and immunohistochemical evaluation led to the diagnosis of hidden gastric carcinoma. The finding of signet ring cells (SRCs) on cutaneous biopsy further added a differential of the rare possibility of primary cutaneous tumors.
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Affiliation(s)
- Sarabjit Kaur
- Department of Dermatology and Venereology and Leprology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India
| | - Parul Aggarwal
- Department of Dermatology and Venereology and Leprology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India
| | - Surabhi Dayal
- Department of Dermatology and Venereology and Leprology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India
| | - Ankita Sangwan
- Department of Dermatology and Venereology and Leprology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India
| | - Vijay Kumar Jain
- Department of Dermatology and Venereology and Leprology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India
| | - Nidhi Jindal
- Department of Dermatology and Venereology and Leprology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India
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99
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Lin TH, Hsieh YC, Win KT, Lai FJ, Feng YH, Lee WY, Chuang SS. Multiple abdominal papules and plaques and mild lymphocytosis. Int J Dermatol 2015; 55:845-8. [PMID: 26463720 DOI: 10.1111/ijd.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 04/16/2015] [Accepted: 05/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Tsung-Hsien Lin
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Yen-Chuan Hsieh
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Khin Than Win
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Feng-Jie Lai
- Department of Dermatology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Yin-Hsun Feng
- Division of Hematology-Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Wen-Ying Lee
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Pathology, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shih-Sung Chuang
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Pathology, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan
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100
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Seradj MH, Naderi N, Peiman S, Saffar H. Metastatic transitional cell carcinoma of the skin presenting as painful zosteriform eruptions. Oxf Med Case Reports 2015; 2015:281-3. [PMID: 26019884 PMCID: PMC4434576 DOI: 10.1093/omcr/omv036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 04/10/2015] [Accepted: 04/12/2015] [Indexed: 11/14/2022] Open
Abstract
Metastatic skin disease is an uncommon manifestation of visceral malignancies and failure to diagnose this early may result in incorrect treatment. Here, we report a 65-year-old man with bilateral painful eruptions on the abdominal skin and a past history of transitional cell carcinoma of urinary bladder.
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Affiliation(s)
- Mehran Heydari Seradj
- Department of Dermatology , Mostafa Khomeini Hospital, Shahed University , Tehran , Iran
| | - Neda Naderi
- Department of Internal Medicine , Imam Khomeini Hospital, Tehran University of Medical Sciences , Tehran , Iran
| | - Soheil Peiman
- Department of Internal Medicine , Imam Khomeini Hospital, Tehran University of Medical Sciences , Tehran , Iran
| | - Hana Saffar
- Department of Pathology , Cancer Institute, Tehran University of Medical Sciences , Tehran , Iran
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