Cutaneous metastases: Where do they come from and what can they mimic?

Metastatic cutaneous deposits as the initial feature of rectal adenocarcinoma

Cutaneous metastases in colorectal cancer are rare, occurring in less than 6% of cases. They usually present after diagnosis of a primary tumour and are typically associated with disseminated disease and a poor prognosis. We present an unusual case of a 71-year-old female in whom cutaneous metastases were the initial feature of an underlying colorectal cancer.

Lung Sarcomatoid Carcinoma Metastasis to Skin: A Case Report and Review of the Literature

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.

Cutaneous metastases of internal tumors

Cutaneous metastases are relatively rare in clinical practice and their diagnosis requires a high index of suspicion because clinical findings can be subtle. These metastases reveal the presence of disseminated malignant disease and can lead to the diagnosis of unsuspected internal tumors or the spread or recurrence of an already diagnosed tumor. Early recognition of cutaneous metastases can facilitate prompt and accurate diagnosis resulting in early treatment; however, they are generally indicative of a poor prognosis. Some tumors have a predilection to metastasize to specific areas. Recognition of these patterns provides essential information that can guide the search for the underlying tumor.

An unusual case of pulmonary adenocarcinoma with multiple and extraordinary metastases

Pulmonary adenocarcinoma is one of the major types of lung cancers in which metastasis is not uncommon. Hereby, we report a case of pulmonary adenocarcinoma with multiple muscular, cutaneous, pancreatic and peritoneal metastases. Actually, all these features occurring in one patient makes it an extraordinary case. A rare anatomic variation, double inferior vena cava (IVCs), was another rare manifestation in this case.

Cutaneous metastasis as the initial manifestation of lung adenocarcinoma

We report the case of a 58-year-old male patient who was referred for oncology consultation due to an epigastric mass that had been growing rapidly for three months. Diagnostic investigation revealed that the mass was a metastasis of stage IV lung adenocarcinoma. The patient received five cycles of chemotherapy with cisplatin and gemcitabine as a first-line treatment, which was interrupted due to major adverse events. Although the pulmonary disease stabilized, the cutaneous disease progressed. The patient then received pemetrexed as a second-line chemotherapy, together with concurrent external radiotherapy, which was well tolerated. There was complete remission of the epigastric mass. However, the patient died three months after the treatment. Here, we emphasize the importance of a multidisciplinary approach and of its role in individualizing the treatment.

Cutaneous metastasis of lung carcinoma: a retrospective study of 12 cases

BACKGROUND

The skin is a rare site of metastasis of the internal malignancies. On the contrary, lung cancer is a common primary malignancy of skin metastasis. The latter is either synchronous with the primary lung tumour or can reveal it.

OBJECTIVE

To analyse the clinical findings and the outcome of cutaneous metastasis in patients with primary lung cancer.

METHODS

Retrospective study including 12 cases of cutaneous metastasis of lung cancer diagnosed in our institution during 6years.

RESULTS

Our patients included three women and nine men with a median age of 59.83years. The cutaneous metastases were unique in seven cases. They revealed the primary tumour in two cases, were discovered synchronously with the primary tumour in six cases and after the primary tumour in four cases. They appeared in patients presenting multiple metastases in 10 cases. Clinical appearance consisted on a firm nodule, sometimes ulcerated with a diameter ranging from 0.5 to 5.5cm. The tumour was sited in the thorax, the back, the abdomen; or the upper or lower limbs. Pathological examination of bronchial biopsy revealed an adenocarcinoma in eight cases, a squamous cell carcinoma in two cases and a small cell carcinoma in two cases. In spite of lung cancer therapies, the patients with metastasis to other organs with a median follow-up time of 4months died.

CONCLUSION

Cutaneous metastases of lung cancer are of poor prognosis. They are most of the time associated with an advanced neoplastic process with metastasis to other organs. Median survival after skin involvement does not exceed months.