Large single cutaneous metastasis of colon adenocarcinoma mimicking a squamous cell carcinoma of the skin: A case report

A large thigh hibernoma in a 23-years-old man: Case report

INTRODUCTION AND IMPORTANCE

Hibernomas are benign soft tissue tumors containing prominent brown adipocytes that resemble normal brown fat, they occur in a wide age range (from 2 to 75 years) and make up for about 1 % of all adipocytic tumors <2 % of benign fatty neoplasms. They have traditionally been regarded as benign tumors with no potential for malignancy; due to their similarity in clinical and radiographical presentation, they are often misdiagnosed as malignant tumors like liposarcomas. While these tumors are generally considered non-malignant, their distinctive characteristics and uncommon occurrence make them an intriguing subject for medical study.

CASE PRESENTATION

This article describes the clinical, radiographic, and histologic features of a young patient with a thigh hibernoma compressing the obturator nerve.

CLINICAL DISCUSSION

Hibernomas are more likely to develop in brown fat-enriched areas in newborns, such as the neck, scapular area, armpit, chest, and retroperitoneum. Increased awareness among clinicians and pathologists, coupled with advances in imaging and immunohistochemistry, has enhanced our ability to accurately identify and treat these intriguing tumors.

CONCLUSION

The rarity of hibernomas together with the close resemblance of their radiological features to those of malignant tumors like liposarcomas or atypical lipomatous tumors, make these lesions extremely difficult to identify and often misdiagnosed. Continued research is essential to further our understanding this neoplasm and refine diagnostic and therapeutic approaches.

Cutaneous Metastasis in Colorectal Cancer: A Rare and Overlooked Phenomenon

Cutaneous metastasis from internal malignancies, indicative of poor prognosis, is rare and often involves primary sources like lung, breast, and colorectal cancer (CRC). This case details a 66-year-old male developing a scalp lesion 10 years post colon adenocarcinoma diagnosis. The challenging medical journey included a comprehensive biopsy confirming metastatic CRC in cutaneous tissue through CDX2 and CK20 positivity, emphasizing the importance of advanced diagnostic techniques. Despite medical advancements, the patient's unfavorable prognosis led to succumbing within a year, highlighting challenges in managing such cases and the need for vigilant post-diagnosis care. This report underscores the limited understanding of cutaneous metastasis, emphasizing the role of immunostaining and prompting awareness for early detection and tailored treatment. Further research into atypical metastasis mechanisms is crucial for improved prognostic outcomes and enhanced comprehension of these complex manifestations.

Axillary cutaneous metastasis of colon cancer with microsatellite instability-high and BRAF V600E mutation treated with curative-intent surgery: a case report

BACKGROUND

Colorectal cancer (CRC) metastasizes to various organs, while cutaneous metastases are rare. Although there have been several previous reports of axillary cutaneous metastases with other metastases of CRC, there has never been a report of axillary cutaneous metastasis of CRC that could be treated with curative-intent surgery.

CASE PRESENTATION

A 68-year-old female was diagnosed with an axillary cutaneous tumor and ascending colon cancer with invasion to the duodenum. Histopathological and immunohistochemical analysis revealed that the axillary cutaneous tumor showed adenocarcinoma and the same expression pattern for cytokeratin 7, cytokeratin 20, and CDX2 as the ascending colon cancer, and that proved to be KRAS-NRAS wild type, MSI-H, and with a BRAF V600E mutation. The patient underwent a two-stage resection with curative intent after receiving neoadjuvant chemotherapy which consisted of one cycle of modified FOLFOX6 followed by two cycles of FOLFOXIRI. During and after the two operations, the patient received a total of nine cycles of modified FOLFOX6 as adjuvant chemotherapy. Two years after the initial surgery, and 1 year and 8 months after the second surgery, the patient is alive without recurrence.

CONCLUSIONS

To the best of our knowledge, this is the first report of axillary cutaneous metastasis of CRC with microsatellite instability-high and BRAF V600E mutation that could be treated with curative-intent surgery. It is important to recognize the presence of such cases for the accurate diagnosis and treatment of CRC with cutaneous metastasis.

Acrometastasis: The Tip of the Iceberg of Metastatic Disease from Thyroid Cancer. Two Cases Report

Acrometastasis, especially in the hands and fingers, is a rare clinical condition resulting from primary cancers such as lung, breast, kidney, and, rarely, thyroid cancer. Acrometastasis tends to be the tip of the iceberg in patients with extensive systemic disease, which could be regional, pulmonary, skeletal, neurological, or all of them combined. Even though these tumors are clearly visible and symptomatic, the diagnosis is usually misleading because such distal metastatic disease is not thought of at first. In general, systemic treatments should be given to any patient presenting digital acrometastasis. We describe two cases of papillary thyroid carcinoma and digital acrometastasis as a sign of advanced disease.

Peristomal adenocarcinoma 16 years after colorectal adenocarcinoma resection with curative intent

Metachronous colorectal cancer is relatively rare, occurring in 0.7-3.6% of patients diagnosed with colorectal adenocarcinoma. Cutaneous metastases are similarly a rare presentation, occurring in <6% of metastatic colorectal cancer patients. Even more rare are the cutaneous recurrences at the peristomal site. Clinically, it is difficult to distinguish between metachronous cancer and cutaneous metastases. This paper reports a case of an elderly woman presenting with a slowly progressing peristomal cutaneous lesion 16 years after surgical resection for colorectal cancer. Core punch biopsy revealed a cutaneous localization of an intestinal type of adenocarcinoma. A surgical resection of the peristomal area was carried out whereby a new colostomy was created on the contralateral side. Definite histopathological examination showed a superficially located intestinal type adenocarcinoma with extensive pagetoid spread in the epidermal surface. In conclusion, it is important to remain alert and strive for early detection for cutaneous abnormalities following colorectal cancer.

Rare presentation of the cutaneous metastasis of colon cancer imitating herpes zoster

The cutaneous metastasis of colon cancer is rare, and most commonly manifests as nodules or masses. In the case of our patient, a rarely described vesiculomaculopapular rash resembling herpes zoster was observed and treated as such; however, biopsy later revealed metastatic colonic adenocarcinoma. Metastasis of colon cancer to the skin typically confers a poor prognosis, however, early identification may allow for quicker intervention and more aggressive treatments, that may extend survival. Given the immunocompromised state of cancer patients undergoing antineoplastic therapy, a herpes zoster eruption would not be unexpected, but an astute primary care provider should keep metastatic disease in their differential.

Metastases to the nail unit and distal phalanx: a systematic review

Metastases to the nail unit/distal phalanx (NU/DP), although rare, carry a poor prognosis and are frequently misdiagnosed due to variable clinical presentation. Metastases to the NU/DP may be the initial presenting sign of a new or recurrent malignancy. Since the most recent systematic review of case reports (133 patients total) was conducted in 2001, we conducted a systematic review from 1900 to 2021 (244 patients total) to assess any changes in trends in demographics, clinical presentation, and morphology and to report on more updated differential diagnoses. We also examined cases for age, sex, race, ethnicity, Fitzpatrick skin type, laterality, distribution, and diagnostic methods. The PubMed database (1900-2021) was used to detect case-level data per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We found that the most common primary tumors were lung, kidney, and esophagus. A NU/DP metastasis was the presenting sign of malignancy in 31.00% of patients without a former cancer diagnosis. Male to female ratio was 2:1, with average age at diagnosis 58 years. Metastases most often affected a single digit (79.91%), particularly the thumb, followed by the fourth digit. This systematic review corroborates that metastases to the NU/DP may be the initial presenting sign of a new or recurrent malignancy and provides updated diagnostic guidelines. NU/DP metastasis should be considered in both healthy patients and patients with a former malignancy diagnosis presenting with nail changes involving a single digit. Prompt diagnosis and treatment may improve prognosis.

Non-iatrogenic implantation of cutaneous metastasis from hepatocellular carcinoma

PURPOSE

Cutaneous metastases as an extrahepatic metastasis from hepatomas (HCC) is extremely rare and always carry a poor prognosis and less survival time. Previously, there has been a limited number of literature that reported skin metastasis in a large number of cases, which has rarely been discussed in the empirical treatment and therapy of cutaneous metastasis, especially for non-iatrogenic implantation. It is necessary to discuss this kind of metastasis.

PATIENTS AND METHODS

We summarize cases from our medical center from 2013 to 2021, there are 12 patients diagnosed with non-iatrogenic implantation of cutaneous metastasis after HCC. We conducted the investigation of the clinical prognosis, pathological characteristics, and treatment of those patients.

RESULTS

All patients were male, the age ranged from 21 to 71 years old, the average size of primary HCC was over 5 cm, there was four patient's cutaneous metastasis from the skin of head (including scalp and occipital region), followed by right abdominal (2 patients), right chest wall (2 patients), back (2 patients), umbilical (1 patient), gluteal region (1 patient). The cutaneous metastases presented as solitary or multiple nodules, papules, and erythema without ulcers with sizes between 0.5 cm and 5 cm. 7 patients died after being diagnosed with cutaneous metastasis within 2-19 months.

CONCLUSIONS

The rate of non-iatrogenic implantation cutaneous metastasis is low, but the prognosis is poor, combining with histopathological analysis and history of diseases can be helpful in diagnosis. For large HCC (> 5 cm), systematic treatment is recommended to prevent the occurrence of cutaneous metastasis and improve the prognosis after hepatectomy.

Cutaneous Limb Metastasis of Colorectal Cancer Misdiagnosed as Zoster Infection

Cutaneous metastasis is a rare manifestation of internal malignancies. It usually occurs with the later progression of the disease and is associated with a poor prognosis. Common culprits of skin metastasis include lung cancer, melanoma, and colorectal cancer in men and breast cancer, colorectal cancer, and melanoma in women. Given these points, there is a low rate of cutaneous metastasis of colorectal cancer. When present, the most common sites include the abdominal wall and, less frequently, the face and the scalp. Rarely there is cutaneous metastasis to the upper extremity. Herein, we report the case of a female patient in her 50s who presented with a maculopapular rash of the right upper limb four years after her initial diagnosis of colonic adenocarcinoma. However, because of this rare manifestation, she was initially misdiagnosed with more common causes of a maculopapular rash. After a period of no improvement with preliminary treatment, a biopsy with immunohistochemical staining was undertaken, and the specimen stained positive for CK20 and CDX2, confirming metastatic colorectal malignancy. Skin lesions that are not responding to conventional therapy and those which have bizarre presentations can be a harbinger of internal malignancy and should be considered in the differential.

Mondor’s disease as a complication in breast surgery in a male patient. The first ever reported case in literature

Mondor’s disease (MD) is an uncommon clinical condition characterized by thrombophlebitis of the superficial veins of the anterolateral thoracoabdominal wall. In this paper we present the first ever reported case of Mondor’s disease in male patient after surgical correction of gynecomastia with liposuction assisted skin sparing adenectomy.

A rare isolated cutaneous metastatic mass after colon cancer resection

Metastatic cutaneous lesions from colorectal in origin are extremely rare, and especially without any visceral metastasis. Due to its poor response to chemotherapy, it is a poor prognostic indicator with a 1–6 month(s) death rate. Routine screening colonoscopy should be highly encouraged. This case is about a patient with obstructing, bleeding right colon mass and metastatic cutaneous soft tissue mass postcolonic mass resection. The biology and the mechanism of these metastatic lesions are not well understood, and they can be mistaken with any other primary soft tissue malignancy.

Cutaneous Metastasis from Colorectal Cancer: Making Light on an Unusual and Misdiagnosed Event

Cutaneous metastasis from solid tumors is a rare event and usually represents a late occurrence in the natural history of an advanced visceral malignancy. Rarely, cutaneous metastasis has been described in colorectal cancer patients. The most frequent cutaneous site of colorectal metastasis is the surgical scar in the abdomen following the removal of the primary malignancy, followed by the extremities, perineum, head, neck, and penis. Metastases to the thigh and back of the trunk are anecdotical. Dermatological diagnosis of cutaneous metastasis can be quite complex, especially in unusual sites, such as in the facial skin or thorax and in cases of single cutaneous lesions since metastasis from colorectal cancer is not usually the first clinical hypothesis, leading to misdiagnosis. To date, due to the rarity of cutaneous metastasis from colorectal cancer, little evidence, most of which is based on case reports and very small case series, is currently available. Therefore, a better understanding of the clinic-pathological characteristics of this unusual metastatic site represents an unmet clinical need. We present a large series of 29 cutaneous metastases from colorectal cancer with particular concerns regarding anatomic localization and the time of onset with respect to primitive colorectal cancer and visceral metastases.

Unusual Cutaneous Metastases From Colon Adenocarcinoma

Skin metastases from internal malignancies are rare, even more from colorectal tumours, and are usually a sign of disseminated disease with a poor prognosis. However, with increased numbers of cancer survivors, a high index of suspicion should exist during the evaluation of cutaneous lesions since it can be the initial sign of disease progression or even the first sign that triggers a malignancy diagnosis, potentially improving the patient's odds. Herein, we report a case of synchronous cutaneous metastases from colon adenocarcinoma with unusual localization on the back and forearm of a 65-year-old man.

Cutaneous metastasis of a colon adenocarcinoma presenting as an unusual manifestation: a report of one case

Colorectal cancer has a low probability of metastasizing to the skin, usually < 6%, and the common sites of metastasis are the liver and lungs. Skin metastases usually occur within 2 years of the discovery of the primary tumor. Here we report a case in which the skin lesions were mainly characterized by unilateral scattered papules and "fake blisters". The patient was initially misdiagnosed with lymphoma and was ultimately diagnosed with metastatic colorectal cancer through pathology.