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Becker SL, Kody S, Fett NM, Hines A, Alavi A, Ortega-Loayza AG. Approach to the Atypical Wound. Am J Clin Dermatol 2024; 25:559-584. [PMID: 38744780 DOI: 10.1007/s40257-024-00865-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/16/2024]
Abstract
The heterogeneity of atypical wounds can present diagnostic and therapeutic challenges; however, as the prevalence of atypical wounds grows worldwide, prompt and accurate management is increasingly an essential skill for dermatologists. Addressing the underlying cause of an atypical wound is critical for successful outcomes. An integrated approach with a focus on pain management and patient engagement is recommended to facilitate enduring wound closure. Advances in treatment, in addition to further research and clinical training, are necessary to address the expanding burden of atypical wounds.
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Affiliation(s)
- Sarah L Becker
- Department of Dermatology, Oregon Health & Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA
| | - Shannon Kody
- Department of Dermatology, Oregon Health & Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA
| | - Nicole M Fett
- Department of Dermatology, Oregon Health & Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA
| | | | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Alex G Ortega-Loayza
- Department of Dermatology, Oregon Health & Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA.
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Dai Y, Jiang J, Liang P, Yu X, Han Z, Liu F, Tan S, Bi M, Wu C, Cai Q, Li J, Yu J. Percutaneous microwave ablation: a viable local therapy for breast cancer involving the skin/nipple-areola complex? Curr Probl Surg 2024; 61:101483. [PMID: 38823890 DOI: 10.1016/j.cpsurg.2024.101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 06/03/2024]
Affiliation(s)
- Yuqing Dai
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jian Jiang
- Department of Ultrasound, Aerospace Center Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - XiaoLing Yu
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - ZhiYu Han
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fangyi Liu
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shuilian Tan
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Mingsen Bi
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Chong Wu
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qian Cai
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jianming Li
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, 5th Medical Center of Chinese PLA General Hospital, Beijing, China.
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Dicu-Andreescu IG, Marincaș MA, Simionescu AA, Dicu-Andreescu I, Prunoiu VM, Ionescu SO, Neicu ȘA, Radu GM, Brătucu E, Simion L. Abdominal Parietal Metastasis from Cervical Cancer: A Review of One of the Most Uncommon Sites of Recurrence Including a Report of a New Case. Life (Basel) 2024; 14:667. [PMID: 38929651 PMCID: PMC11204997 DOI: 10.3390/life14060667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/19/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Cervical cancer is the fourth most common cancer in women, the highest mortality being found in low- and middle-income countries. Abdominal parietal metastases in cervical cancer are a very rare entity, with an incidence of 0.1-1.3%, and represent an unfavorable prognostic factor with the survival rate falling to 17%. Here, we present a review of cases of abdominal parietal metastasis in recent decades, including a new case of a 4.5 cm abdominal parietal metastasis at the site of the scar of the former drain tube 28 months after diagnosis of stage IIB cervical cancer (adenosquamous carcinoma), treated by external radiotherapy with concurrent chemotherapy and intracavitary brachytherapy and subsequent surgery (type B radical hysterectomy). The tumor was resected within oncological limits with the histopathological result of adenosquamous carcinoma. The case study highlights the importance of early detection and appropriate treatment of metastases in patients with cervical cancer. The discussion explores the potential pathways for parietal metastasis and the impact of incomplete surgical procedures on the development of metastases. The conclusion emphasizes the poor prognosis associated with this type of metastasis in cervical cancer patients and the potential benefits of surgical resection associated with systemic therapy in improving survival rates.
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Affiliation(s)
- Irinel-Gabriel Dicu-Andreescu
- Clinical Department No 10, General Surgery, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (I.-G.D.-A.)
- Department of Oncological Surgery, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Marian-Augustin Marincaș
- Clinical Department No 10, General Surgery, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (I.-G.D.-A.)
- Department of Oncological Surgery, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Anca-Angela Simionescu
- Clinical Department No 10, General Surgery, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (I.-G.D.-A.)
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
| | - Ioana Dicu-Andreescu
- Clinical Department No 10, General Surgery, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (I.-G.D.-A.)
| | - Virgiliu-Mihail Prunoiu
- Clinical Department No 10, General Surgery, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (I.-G.D.-A.)
- Department of Oncological Surgery, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Sânziana-Octavia Ionescu
- Clinical Department No 10, General Surgery, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (I.-G.D.-A.)
- Department of Oncological Surgery, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Ștefania-Ariana Neicu
- Department of Pathological Anatomy, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Gabriela-Mădălina Radu
- Department of Pathological Anatomy, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Eugen Brătucu
- Clinical Department No 10, General Surgery, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (I.-G.D.-A.)
- Department of Oncological Surgery, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Laurențiu Simion
- Clinical Department No 10, General Surgery, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (I.-G.D.-A.)
- Department of Oncological Surgery, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
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Koh NH, Oh HY. Case report: Unusual breast cancer metastasis manifesting as a scalp lesion in a patient with invasive lobular carcinoma. Front Oncol 2024; 14:1361333. [PMID: 38646434 PMCID: PMC11026626 DOI: 10.3389/fonc.2024.1361333] [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] [Received: 12/25/2023] [Accepted: 03/13/2024] [Indexed: 04/23/2024] Open
Abstract
Breast cancer is the most prevalent cancer in women globally, often leading to distant metastasis in the lung, liver, or bones. Cutaneous metastasis represents an uncommon pattern in breast cancer, but when observed, it tends to manifest in the thorax and upper abdomen, primarily due to lymph node involvement. Therefore, occurrences of cutaneous metastasis on the scalp and extremities are infrequent. Moreover, invasive lobular carcinoma metastasizing to remote skin is rare among the breast cancer. This report presents a case of cutaneous metastasis of invasive lobular carcinoma to the scalp in a patient treated for breast cancer six years ago, with no signs of local recurrence or metastasis to other organs.
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Affiliation(s)
| | - Ha Yeun Oh
- Department of Radiology, Kangwon National University Hospital, Chuncheon, Republic of Korea
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Hao W, Chang R, Liu J, Wang Y, Ren M, Xin K, Liu B, Xie J, Yang Y. Case report: A case of advanced gastric cancer with multiple skin metastases, with significant relief from immunotherapy. Front Immunol 2024; 15:1356350. [PMID: 38500887 PMCID: PMC10946408 DOI: 10.3389/fimmu.2024.1356350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/06/2024] [Indexed: 03/20/2024] Open
Abstract
Gastric cancer is the fifth leading cause of cancer-related mortality worldwide, with a low 5-year survival rate in advanced stages. Cutaneous metastasis is rare in gastric cancer, with only 0.8-1% incidence. We reported a rare case of female gastric cancer. The patient had undergone subtotal gastrectomy and chemotherapy 13 years ago, followed by a subsequent surgery of residual stomach, partial jejunum, and partial colon resection 11 years later. The pathological examination revealed poorly differentiated stomach adenocarcinoma, Lauren classification: diffuse type. The patient received 2 cycles of SOX chemotherapy. Two years later, cauliflower-like skin nodules, which were surgically excised, appeared on the back. The histopathological examination showed a spindle cell tumor; no specific anti-tumor treatment was administered. Six months later, the skin lesions increased in size and number, spreading to the neck, chest, and abdomen, presenting as erythematous patches with some cauliflower-like elevations. A skin biopsy of a 1cm0.5cm0.3cm lesion on the left abdomen was performed, and based on the immunohistochemistry, clinical history, and the possibility of metastatic or infiltrating adenocarcinoma, the gastrointestinal origin was highly suspected. Genetic testing was performed on the gastric recurrence and skin lesions, revealing 103 shared genetic variations, further suggesting the skin metastasis originated from gastric cancer. Subsequently, the patient received 10 cycles of immunotherapy combined with intravenous chemotherapy (200mg Tislelizumab and 100mg albumin-bound paclitaxel). The treatment response was evaluated as partial remission, with significant improvement in the skin lesions compared to before. This case highlights the possibility of tumor metastasis in patients with extensive skin lesions in advanced gastric cancer. Early examination, diagnosis, skin biopsy, immunohistochemistry, and genetic sequencing are recommended.
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Affiliation(s)
- Wen Hao
- Department of Oncology, Nanjing Drum Tower Hospital, Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Ruimin Chang
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jingxin Liu
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yibing Wang
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Meijin Ren
- Department of Oncology, Nanjing Drum Tower Hospital, Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Kai Xin
- Department of Oncology, Nanjing Drum Tower Hospital, Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Baorui Liu
- Department of Oncology, Nanjing Drum Tower Hospital, Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jiaqi Xie
- Department of Oncology, Nanjing Drum Tower Hospital, Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yang Yang
- Department of Oncology, Nanjing Drum Tower Hospital, Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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Murphy CM, Wang K, Wachuku C, Prasad A, Dhawan I, Morgan EE, Brown KK, Wang L. Metastatic gastric adenocarcinoma to the cutaneous neck and chest wall. SAGE Open Med Case Rep 2024; 12:2050313X241231515. [PMID: 38404499 PMCID: PMC10894527 DOI: 10.1177/2050313x241231515] [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] [Received: 11/09/2023] [Accepted: 12/11/2023] [Indexed: 02/27/2024] Open
Abstract
This case describes an atypical cutaneous presentation of metastatic gastric carcinoma in a patient initially presenting with dysphagia and a sclerotic red plaque overlying the anterior neck and chest. Skin biopsy revealed metastatic adenocarcinoma from the upper gastrointestinal tract. Esophagogastroduodenoscopy revealed stage IV metastatic gastric adenocarcinoma. Treatment with chemotherapy was initiated.
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Affiliation(s)
- Christina M Murphy
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kevin Wang
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | | | - Aman Prasad
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ishita Dhawan
- Division of Gastroenterology, Cooper University Hospital, Camden, NJ, USA
| | - Eric E Morgan
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Katherine K Brown
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Leo Wang
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
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Tian L, Ye ZB, Du YL, Li QF, He LY, Zhang HZ. Inflammatory cutaneous metastases originating from gastric cancer: A case report. World J Clin Cases 2023; 11:8411-8415. [PMID: 38130616 PMCID: PMC10731189 DOI: 10.12998/wjcc.v11.i35.8411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/22/2023] [Accepted: 12/04/2023] [Indexed: 12/14/2023] Open
Abstract
BACKGROUND Cutaneous metastasis with gastric cancer (GC) origin is extremely rare and associated with poor prognosis. Nodular type is the most common type, while other forms are extremely rare. CASE SUMMARY This study describes severe skin redness, swelling, pain, and fever in a 65-year-old man diagnosed with GC, whose left chest wall, left upper limb, and left back were mainly affected. Firstly, the patient was diagnosed with "lymphangitis" and treated to promote lymphatic return. However, the symptoms were constantly deteriorating, and skin thickening and scattered small nodules gradually appeared. Finally, the skin biopsy confirmed cutaneous metastases, and the patient died 7 d later. CONCLUSION Our case highlights that cutaneous metastasis should be considered when skin lesions appear in patients with GC.
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Affiliation(s)
- Lei Tian
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Zhi-Bin Ye
- Department of Gastrointestinal Surgery, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Yun-Lei Du
- Department of Emergency, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Qiao-Fang Li
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Li-Ya He
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Hong-Zhen Zhang
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
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Yamai D, Shimada Y, Ozeki H, Matsumoto A, Abe K, Tajima Y, Nakano M, Ichikawa H, Sakata J, Wakai T. Axillary cutaneous metastasis of colon cancer with microsatellite instability-high and BRAF V600E mutation treated with curative-intent surgery: a case report. Surg Case Rep 2023; 9:196. [PMID: 37962682 PMCID: PMC10646071 DOI: 10.1186/s40792-023-01780-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023] Open
Abstract
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.
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Affiliation(s)
- Daisuke Yamai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
- Medical Genome Center, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan.
| | - Hikaru Ozeki
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Akio Matsumoto
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Kaoru Abe
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Yosuke Tajima
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Mae Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
- Medical Genome Center, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
- Medical Genome Center, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan
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Shin DM, Jung YJ, Kim H, Oh SJ, Shim J, Lee JH, Lee DY, Park J. Clinical characteristics and survival analysis of cutaneous metastases in a single tertiary centre in Korea. J Eur Acad Dermatol Venereol 2023; 37:2311-2318. [PMID: 37467154 DOI: 10.1111/jdv.19361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/30/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Cutaneous metastasis (CM) refers to the spread of malignancy to the skin. CM is perceived as an advanced stage. It might be the first sign of a primary cancer or an indicator of recurrence. OBJECTIVES To identify primary cancers associated with CMs and perform a survival analysis according to advanced stage of cutaneous metastasis at a single tertiary centre in Korea. METHODS A total of 219 patients from Samsung Medical Center from January 2009 to April 2020 were retrospectively analysed to identify cases with biopsy-proven CMs. According to advanced stage of metastasis, patients were divided into three stages, CM only (CMO), CM with lymph node metastasis (CM/LM) and CM with distant metastasis (CM/DM), to analyse clinical characteristics and survival rate. RESULTS The most common CM from primary cancer was breast cancer, followed by lung cancer, stomach cancer, colorectal cancer and others. When all primary cancers were included, the median survival period was 4.82 years for the CMO stage, 2.15 years for the CM/LM stage and 0.80 years for the CM/DM stage, with a tendency to deteriorate with advancing stage. At 1- and 3-year after occurrence of CM, the CM/DM stage showed a significantly poorer survival rate than the other two stages. CONCLUSIONS This study showed a median survival period of 22 months for CM patients overall. Breast cancer has greater accessibility to the skin than other cancers. Therefore, breast cancer can metastasize to the skin without involving lymph nodes or other sites.
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Affiliation(s)
- Dong Min Shin
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yeon Joo Jung
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Heeyeon Kim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Se Jin Oh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Joonho Shim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Hee Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Dong-Youn Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jihye Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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10
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Baykal C, Polat Ekinci A. Annular skin tumors and lymphoproliferative diseases. Clin Dermatol 2023; 41:692-711. [PMID: 37586571 DOI: 10.1016/j.clindermatol.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Determining the shape of a skin lesion may provide a diagnostic clue in dermatology practice, more commonly for inflammatory diseases but also for skin tumors. The annular formation may develop by diverse mechanisms in skin tumors. Annular lesions may occur from the onset of the tumor as sparing the central area or depression and/or ulceration in the center of the tumor or outward expansion of the primary lesion. Clustering of multiple papulonodular lesions sparing the central area or relatively independent processes acting on the central and peripheral components of the tumor may also result in an annular appearance. We have explored a wide variety of benign and malignant skin tumors and lymphoproliferative diseases forming an annular shape.
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Affiliation(s)
- Can Baykal
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Algün Polat Ekinci
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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11
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Li S, Cai X, Yu K, Pan W. Nasal Tip Cutaneous Metastasis of Hepatocellular Carcinoma: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:2893-2897. [PMID: 37869532 PMCID: PMC10590066 DOI: 10.2147/ccid.s429480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023]
Abstract
Background Cutaneous metastasis is rare in clinical practice, especially that from primary hepatocellular carcinoma (HCC), which is even rarer. Case Presentation This report describes a male patient with HCC with cutaneous metastases to the nasal tip. The patient developed a raised nodule at the nasal tip 5 years after surgery for HCC, with surface ulceration and crusting and no obvious symptoms. Abdominal computed tomography (CT) showed an obvious mass in the liver. The skin lesions on the nasal tip were confirmed to be cutaneous metastasis of HCC by histopathological and immunohistochemical examinations. Conclusion The incidence of cutaneous metastasis of HCC is extremely low, and nasal tip cutaneous metastasis of HCC has no specific clinical manifestations; therefore, it needs to be distinguished from rosacea rhinophyma, fungal and atypical mycobacterial infections, tumours of vascular origin, and tumours of skin appendages that occur in the nasal tip and is prone to misdiagnosis and missed diagnosis, thus requiring clinical dermatologists and otolaryngologists to be aware of such metastasis.
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Affiliation(s)
- Songting Li
- Department of Dermatology, Second Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai, People’s Republic of China
| | - Xiaolan Cai
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Keyao Yu
- Department of Dermatology, Second Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai, People’s Republic of China
| | - Weihua Pan
- Department of Dermatology, Second Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai, People’s Republic of China
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12
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Bonometti A. Cutaneous involvement in Ph-negative myeloproliferative neoplasms: from extramedullary hematopoiesis to myeloid metastasis with histiocytic differentiation. A systematic review of the literature. Int J Dermatol 2023; 62:1228-1236. [PMID: 37649236 DOI: 10.1111/ijd.16809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 09/01/2023]
Abstract
Myeloid neoplasms may metastasize to the skin, presenting a wide range of clinical-pathological features that often lead to a reduction in patients' survival. The presentation varies depending on the category of myeloid neoplasm and its prognostic significance. The literature has specifically focused on the features of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and chronic myelomonocytic leukemia (CMML). In this article, we aimed to uncover the peculiarities of clonal skin proliferations in the course of Ph-negative myeloproliferative neoplasms (MPNs). We conducted a systematic review and statistical analysis of the literature data. MPN patients mainly exhibited cutaneous extramedullary hematopoiesis, while a minority displayed cutaneous histiocytic lesions. Furthermore, these patients showed lower survival rates compared to the median survival of MPN patients, especially when calculating survival from the appearance of cutaneous lesions. Our work highlights, for the first time, the prognostic relevance and histological heterogeneity of cutaneous lesions in MPN. Moreover, it emphasizes the importance of dermatological and histological examinations when cutaneous lesions are present.
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Affiliation(s)
- Arturo Bonometti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Pathology, IRCCS Humanitas Clinical and Research Hospital, Milan, Italy
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13
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Vissing M, Pervan M, Pløen J, Schnefeldt M, Rafaelsen SR, Jensen LH, Rody A, Gehl J. Calcium electroporation in cutaneous metastases - A non-randomised phase II multicentre clinical trial. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:106925. [PMID: 37268521 DOI: 10.1016/j.ejso.2023.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/26/2023] [Accepted: 04/30/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Cutaneous metastases can cause distressing symptoms and be challenging to treat. Local therapies are essential in management. Calcium electroporation uses calcium and electrical pulses to selectively kill cancer cells. This multicentre study aimed to define response in cutaneous metastases across different cancer types. METHODS Patients with tumours ≤3 cm of any histology were included (stable or progressing on current therapy ≥2 months), at three centres. Tumours were treated with 220 mM calcium chloride injection and manual application of eight 0.1 ms pulses with 1 kV/cm and 1Hz with a handheld electrode, in local or general anaesthesia. Clinical response was evaluated after 1, 2, 3, 4, 5, 6, and 12 months. Primary endpoint was response at two months. The overall response rate (ORR) was partial- and complete responses of treated tumours. MR-imaging and qualitative interviews were performed in respective subsets. RESULTS Nineteen patients with disseminated cancer (breast n = 4, lung n = 5, pancreatic n = 1, colorectal n = 2, gastric n = 1, and endometrial cancer n = 1) were enrolled, and 58 metastases were treated (50 once, 8 retreated). The ORR was 36% (95% CI 22-53) after two months. Best ORR was 51% (CR 42%; PR 9%). Previous irradiation improved outcomes (p = 0.0004). Adverse events were minimal. Median pain score was reduced after two months (p = 0.017). Treatment may relieve symptoms according to qualitative interviews. MRI showed restriction in treated tissue. CONCLUSION The majority of tumours were treated only once with calcium electroporation, achieving an ORR of 36% after two months and best ORR of 51%. Efficacy, symptom-relief and safety support calcium electroporation as a palliative treatment option for cutaneous metastases.
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Affiliation(s)
- Mille Vissing
- Center for Experimental Drug and Gene Electrotransfer (C∗EDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde and Næstved, Ringstedgade 61, 4700, Næstved, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Mascha Pervan
- Department of Gynaecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Germany Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - John Pløen
- Department of Oncology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
| | - Mazen Schnefeldt
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
| | - Søren Rafael Rafaelsen
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
| | - Lars Henrik Jensen
- Department of Oncology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
| | - Achim Rody
- Department of Gynaecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Germany Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (C∗EDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde and Næstved, Ringstedgade 61, 4700, Næstved, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
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14
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Baykal C, Ekinci AP. Annular skin tumors and lymphoproliferative diseases. Clin Dermatol 2023; 41:382-395. [PMID: 37421997 DOI: 10.1016/j.clindermatol.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
Determining the shape of the skin lesion may provide a diagnostic clue in dermatology practice, more commonly for inflammatory diseases but also for skin tumors. The annular formation may develop by diverse mechanisms in skin tumors. Annular lesions may occur from the onset of the tumor as sparing the central area or depression and/or ulceration in the center of the tumor or outward expansion of the primary lesion. Clustering of multiple papulonodular lesions sparing the central area or relatively independent processes acting on the central and peripheral components of the tumor may also result in an annular appearance. We have explored a wide variety of benign and malignant skin tumors and lymphoproliferative diseases forming an annular shape.
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Affiliation(s)
- Can Baykal
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Algün Polat Ekinci
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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15
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Hayoune Z, Ramdani M, Tahri Y, Barki A. Late Cutaneous Metastases of Bladder Urothelial Carcinoma: A Case Report. Cureus 2023; 15:e38038. [PMID: 37228517 PMCID: PMC10208017 DOI: 10.7759/cureus.38038] [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] [Accepted: 04/23/2023] [Indexed: 05/27/2023] Open
Abstract
Cutaneous metastatic disease from bladder urothelial carcinoma is a rare but serious complication of advanced bladder cancer. It occurs when malignant cells from the primary bladder tumor spread to the skin. The most common sites for cutaneous metastases from bladder cancer are the abdomen, chest, and pelvis. We report a case of a 69-year-old patient who was diagnosed with infiltrative urothelial carcinoma of the bladder (pT2) and underwent a radical cystoprostatectomy. After one year, the patient developed two ulcerative-bourgeous lesions, which were later identified as cutaneous metastases from bladder urothelial carcinoma through histological examination. Unfortunately, the patient passed away a few weeks later.
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Affiliation(s)
- Zakariae Hayoune
- Urology, Mohammed VI University Hospital, Oujda, MAR
- Urology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | | | - Youness Tahri
- Urology, Mohammed VI University Hospital, Oujda, MAR
| | - Ali Barki
- Urology, Mohammed VI University Hospital, Oujda, MAR
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16
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Jia J, Luo J, Zou B, Feng M, Liu L, Yu S, Zheng S, Yu J. Non-iatrogenic implantation of cutaneous metastasis from hepatocellular carcinoma. J Cancer Res Clin Oncol 2023; 149:1513-1519. [PMID: 35536361 DOI: 10.1007/s00432-022-04030-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/15/2022] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Junjun Jia
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qing Chun Road, Hangzhou, 310003, China
| | - Jia Luo
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qing Chun Road, Hangzhou, 310003, China
- NHC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou, China
- Key Laboratory of Organ Transplantation, Hangzhou, 310003, Zhejiang Province, China
| | - Bei Zou
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qing Chun Road, Hangzhou, 310003, China
| | - Meibao Feng
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Li Liu
- Department of Library, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Songfeng Yu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qing Chun Road, Hangzhou, 310003, China
| | - Shusen Zheng
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qing Chun Road, Hangzhou, 310003, China.
- NHC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou, China.
- Key Laboratory of Organ Transplantation, Hangzhou, 310003, Zhejiang Province, China.
| | - Jun Yu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qing Chun Road, Hangzhou, 310003, China.
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17
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Abbott JJ, Jiang AJ, Rauck C, Frank DM, Fortuna D, Kersh A, Rubin AI. Cutaneous metastatic gastric carcinoma with plasmacytoid features: A novel histopathologic pitfall in the diagnosis of primary cutaneous plasmacytoma. J Cutan Pathol 2023; 50:8-11. [PMID: 35759346 DOI: 10.1111/cup.14269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/09/2022] [Accepted: 05/31/2022] [Indexed: 01/03/2023]
Affiliation(s)
- James J Abbott
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Angela J Jiang
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Corinne Rauck
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Dale M Frank
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Danielle Fortuna
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anna Kersh
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Adam I Rubin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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18
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Broderick JT, McDaniel MH, Lloyd BA, Rohan CA. Development of carcinoma erysipeloides from malignant seeding along a pleural catheter tract in a patient with primary lung adenocarcinoma. JAAD Case Rep 2022; 31:105-108. [PMID: 36568891 PMCID: PMC9771712 DOI: 10.1016/j.jdcr.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- John T. Broderick
- Department of Dermatology, Wright State University Boonshoft School of Medicine, Dayton, Ohio,Correspondence to: John T. Broderick, BS, Department of Dermatology, Wright State University Boonshoft School of Medicine, 3648 Lilac Ln. Unit 3, Beavercreek, OH, 45431.
| | - Mary H. McDaniel
- Department of Dermatology, Wright State University Boonshoft School of Medicine, Dayton, Ohio
| | - Bradley A. Lloyd
- Department of Dermatology, Dayton VA Medical Center, Dayton, Ohio
| | - Craig A. Rohan
- Department of Dermatology, Wright State University Boonshoft School of Medicine, Dayton, Ohio,Department of Dermatology, Dayton VA Medical Center, Dayton, Ohio,Department of Pharmacology and Toxicology, Wright State University Boonshoft School of Medicine, Dayton, Ohio
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19
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Sakai M, Kashiwagi N, Nakanishi K, Maeda N, Nakaya Y, Tanaka J, Watanabe S, Hongyo H, Tanaka Y, Yamada S, Kawata A, Toda S, Takano K, Arita H, Tomiyama N. Nonbrain metastases seen on magnetic resonance imaging during metastatic brain tumor screening. Jpn J Radiol 2022; 41:367-381. [PMID: 36374473 PMCID: PMC10066091 DOI: 10.1007/s11604-022-01362-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022]
Abstract
AbstractAlthough metastases found during head magnetic resonance imaging (MRI) are not limited to metastatic brain tumors, the MRI is a very common method for “brain metastasis screening,” a modality that is being increasingly performed. In this review, we describe MRI findings of nonbrain metastases and discuss ways to avoid missing these lesions. Metastatic cranial bone tumors are among the most common nonbrain metastatic lesions found on head MRI, followed by leptomeningeal carcinomatosis. The other less-frequent metastatic lesions include those in the ventricle/choroid plexus, the pituitary gland and stalk, and the pineal gland. Metastases in the head and neck area, as well as cranial and intracranial lesions, should be carefully evaluated. Furthermore, direct geographical invasion, perineural spread, and double cancers should also be considered. While it is important to recognize these metastatic lesions on MRI, because they may necessitate a change in treatment strategy that could lead to an improvement in prognosis due to early introduction of therapy, nonbrain lesions should also be given greater attention, given the increasing survival of patients with cancer and advances in MRI technology, such as contrast-enhanced-3D T1-weighted imaging.
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Affiliation(s)
- Mio Sakai
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan.
| | - Nobuo Kashiwagi
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Katsuyuki Nakanishi
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Noboru Maeda
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Yasuhiro Nakaya
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Junichiro Tanaka
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Shinichiro Watanabe
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Hidenari Hongyo
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Yu Tanaka
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Sawaka Yamada
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Atsushi Kawata
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Sou Toda
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Koji Takano
- Department of Neurosurgery, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Hideyuki Arita
- Department of Neurosurgery, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
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20
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Hao Z, Deng Y, He Y, Xiong X. Signet-Ring Cutaneous Metastasis Presenting with Huge Bunches of Grapes. Clin Cosmet Investig Dermatol 2022; 15:1997-2001. [PMID: 36172248 PMCID: PMC9512062 DOI: 10.2147/ccid.s378478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022]
Abstract
Signet-ring cell (SRC) is a histologic type in which cells show unique features under the microscope. We mainly found signet-ring cells (SRCs) in gastrointestinal and breast tumors. Cutaneous metastasis from internal carcinomas was an uncommon presentation. The cases of signet-ring cell carcinoma (SRCC) metastasis to the skin were rarely reported. Cutaneous metastasis indicated a poor prognosis for a patient. Here, we report a female who had huge grape-like nodules arising from gastrointestinal SRCC in her trunk and thigh.
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Affiliation(s)
- Zhenyu Hao
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Yongqiong Deng
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Yuanmin He
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Xia Xiong
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
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21
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Newcomer JB, Durbin A, Wilson C. Cutaneous Metastasis of Lung Adenocarcinoma: Initially Mimicking and Misdiagnosed as Keloids. Cureus 2022; 14:e27285. [PMID: 36039229 PMCID: PMC9406242 DOI: 10.7759/cureus.27285] [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] [Accepted: 07/26/2022] [Indexed: 11/05/2022] Open
Abstract
Cutaneous metastases have distinct morphologic features that can aid in making the diagnosis clinically even prior to biopsy. Lesions often have a nodular appearance and are firm, fixed, and range from flesh-colored to reddish-purple. A 73-year-old female with a history of lung adenocarcinoma status-post neoadjuvant chemotherapy and lobectomy 20 months prior was referred to our dermatology clinic for evaluation and treatment of suspected keloids on the left flank. The lesions were firm, plum-colored, fibrotic nodules, and were diagnosed clinically in the office as cutaneous metastases of internal malignancy. Punch biopsy was performed and revealed a proliferation of atypical epithelial cells arranged in cords and strands, with neoplastic cells positive for CK7 and TTF-1, confirming the diagnosis of metastatic adenocarcinoma. The patient was referred for chemotherapy and is still alive nine months following the prompt clinical diagnosis of cutaneous metastasis. Cutaneous metastasis signifies a poor prognosis, but knowledge of the clinical characteristics of these lesions can lead to earlier detection and more prompt initiation of treatment.
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22
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Polintan ETT, Aquino FJ, Liangco W, Lojo R. Postoperative Drain Site Seeding to the Abdominal Wall of Sigmoid Adenocarcinoma: A Case Report and Literature Review. Cureus 2022; 14:e26118. [PMID: 35875286 PMCID: PMC9298959 DOI: 10.7759/cureus.26118] [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] [Accepted: 06/20/2022] [Indexed: 11/19/2022] Open
Abstract
Colorectal carcinoma (CRC) is a very common cancer found worldwide. When metastasizing, it would often seed the liver via traveling through the portal circulation; however, locoregional metastasis is also possible. Abdominal wall seeding postoperatively has been described to happen rarely in those who underwent definitive surgery for CRC. Currently, five case reports are in publication describing this phenomenon. Here, we present a case of a drain site abdominal wall tumor recurrence after definitive surgery with curative intent of a sigmoid adenocarcinoma. Those with higher tumor-node-metastasis (TNM) staging and a primary site at the sigmoid colon were found to be at a higher risk for recurrence. Despite this, abdominal wall recurrence of CRC is exceptionally rare, with less than 1% of those with locoregional recurrence presenting at the incision site or trocar site placement. Because of the rarity of this complication, few studies are available that detail the management of abdominal wall recurrence of CRC. Further studies on this subject are currently warranted.
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23
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Niebel D, Kranert P, Berneburg M, Drexler K, Eichborn MI, Braess J, Allgäuer M, Karrer S. Indurated erythema of abdominal skin: An unusual presentation of metastatic endometrial carcinoma—Case report with literature review. SKIN HEALTH AND DISEASE 2022; 3:e136. [PMID: 37013123 PMCID: PMC10066756 DOI: 10.1002/ski2.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 11/07/2022]
Abstract
Carcinoma erysipelatoides (CE) is a rare clinical manifestation of cutaneous metastasis, which mimics inflammatory conditions such as erysipelas. Depending on the site of the originating tumour, unusual manifestations involving different sites of the body may occur. We herein report a case of a 60-year-old female patient with metastatic endometrial carcinoma presenting as CE of the abdominal skin and the inguinal folds. Even though the diagnosis of advanced malignancy had been established before and she was currently receiving chemotherapy (carboplatin and paclitaxel), the clinical appearance closely resembled fungal (candidal intertrigo) and consecutively bacterial (erysipelas) infection, which resulted in treatment with antimycotics and antibiotics at first. Dermatohistopathological examination of skin biopsies revealed a diffuse and nodular infiltrate of pleomorphic atypical tumour cells with strong expression of cytokeratin 7 and PAX8, also detectable within lymphatic vessels. Therapy comprised antiseptic ointments to prevent superinfection, palliative electron beam radiation and supportive care. Since there were no targetable KRAS-, NRAS- and BRAF-gene mutations, systemic therapy was switched to checkpoint inhibition (pembrolizumab) in combination with lenvatinib. The overall prognosis of cutaneous metastasis of endometrial carcinoma is dismal with most patients succumbing to disease within few months. Similarly, our patient died after 3 months due to sepsis in the course of malignant pleural effusion. We aim to highlight the possibility of unusual sites of CE and the risk of respective clinical misdiagnoses.
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Affiliation(s)
- Dennis Niebel
- Department of Dermatology University Hospital Regensburg Regensburg Germany
| | - Paula Kranert
- Department of Dermatology University Hospital Regensburg Regensburg Germany
| | - Mark Berneburg
- Department of Dermatology University Hospital Regensburg Regensburg Germany
| | - Konstantin Drexler
- Department of Dermatology University Hospital Regensburg Regensburg Germany
| | | | - Jan Braess
- Clinic for Oncology and Hematology Krankenhaus der Barmherzigen Brüder Regensburg Germany
| | - Michael Allgäuer
- Clinic for Radiation Therapy Krankenhaus der Barmherzigen Brüder Regensburg Germany
| | - Sigrid Karrer
- Department of Dermatology University Hospital Regensburg Regensburg Germany
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24
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Pliakou E, Lampropoulou D, Nasi D, Aravantinos G. Skin metastases from gastric cancer, a rare entity masquerading as erysipelas: A case report. Mol Clin Oncol 2022; 16:110. [DOI: 10.3892/mco.2022.2543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/06/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Evangelia Pliakou
- Second Department of Medical Oncology, General Oncology Hospital of Kifissia ‘Agioi Anargiroi’, Athens 14564, Greece
| | - Dimitra Lampropoulou
- Second Department of Medical Oncology, General Oncology Hospital of Kifissia ‘Agioi Anargiroi’, Athens 14564, Greece
| | - Despoina Nasi
- Second Department of Medical Oncology, General Oncology Hospital of Kifissia ‘Agioi Anargiroi’, Athens 14564, Greece
| | - Gerasimos Aravantinos
- Second Department of Medical Oncology, General Oncology Hospital of Kifissia ‘Agioi Anargiroi’, Athens 14564, Greece
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25
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González-Martínez S, Pizarro D, Pérez-Mies B, Caniego-Casas T, Rodríguez-Peralto JL, Curigliano G, Cortés A, Gión M, Cortés J, Palacios J. Differences in the Molecular Profile between Primary Breast Carcinomas and Their Cutaneous Metastases. Cancers (Basel) 2022; 14:cancers14051151. [PMID: 35267459 PMCID: PMC8909188 DOI: 10.3390/cancers14051151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 01/01/2023] Open
Abstract
Simple Summary The development of new strategies for the management of cutaneous metastases is a major clinical challenge because of the poor prognosis. To advance in this field, a better understanding of the molecular alterations involved in the metastatic process is needed. In the present study, the clinicopathological characteristics of breast cancer that develop cutaneous metastases were analyzed and the molecular differences between primary breast tumors and their corresponding cutaneous metastases were compared. We observed that the surrogate molecular type of breast cancer with an increased risk to metastasize to the skin was triple negative. In total, 48.5% of the cutaneous metastases presented some additional molecular alteration with respect to the primary tumor. However, no characteristic mutational pattern related to skin metastasis development was observed. Identifying the genes involved in the development of cutaneous metastases is important to gain insights into the biology of the disease and to identify possible diagnostic and therapeutic biomarkers. Abstract Background: The characterization of molecular alterations of primary breast carcinomas (BC) and their cutaneous metastases (CM) to identify genes involved in the metastatic process have not yet been completely accomplished. Methods: To investigate the molecular alterations of BC and their CM, a total of 66 samples (33 BC and 33 CM) from 33 patients were analyzed by immunohistochemical and massive parallel sequencing analyses. In addition, the clinicopathological characteristics of patients and tumors were analyzed. Results: Triple negative (TN) BCs were overrepresented (36.4%) among tumors that developed CM. A change of tumor surrogate molecular type in metastases was found in 15% of patients and 48.5% of the CM presented some additional molecular alteration with respect to the primary tumor, the most frequent were amplification of MYC and MDM4, and mutations in TP53 and PIK3CA. Survival was related to histological grade, tumor surrogate molecular type and TP53 mutations in the univariate analysis but only the tumor surrogate molecular type remained as a prognostic factor in the multivariate analysis. Conclusions: The TN molecular type has a greater risk of developing skin metastases. There are phenotypic changes and additional molecular alterations in skin metastases compared to the corresponding primary breast tumors in nearly half of the patients. Although these changes do not follow a specific pattern and varied from patient to patient, they could impact on the treatment. More studies with larger patient and sample cohorts are needed.
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Affiliation(s)
- Silvia González-Martínez
- Clinical Research, Ramón y Cajal Hospital, 28034 Madrid, Spain;
- “Contigo Contra el Cáncer de la Mujer” Foundation, 28010 Madrid, Spain
| | - David Pizarro
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
| | - Belén Pérez-Mies
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
- Department of Pathology, Ramón y Cajal University Hospital, 28034 Madrid, Spain
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- Faculty of Medicine, University of Alcalá, 28801 Madrid, Spain
| | - Tamara Caniego-Casas
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
| | - José Luis Rodríguez-Peralto
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- I+D Institute, 12 de Octubre University Hospital, 28041 Madrid, Spain
- Department of Pathology, Medical School, Complutense University, 28040 Madrid, Spain
| | - Giuseppe Curigliano
- European Institute of Oncology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), 20141 Milan, Italy;
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Alfonso Cortés
- Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain; (A.C.); (M.G.)
| | - María Gión
- Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain; (A.C.); (M.G.)
| | - Javier Cortés
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
- International Breast Cancer Center (IBCC), Quironsalud Group, 08017 Barcelona, Spain
- Medica Scientia Innovation Research, 08007 Barcelona, Spain
- Medica Scientia Innovation Research, Ridgewood, NJ 07450, USA
- Correspondence: (J.C.); (J.P.)
| | - José Palacios
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
- Department of Pathology, Ramón y Cajal University Hospital, 28034 Madrid, Spain
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- Faculty of Medicine, University of Alcalá, 28801 Madrid, Spain
- Correspondence: (J.C.); (J.P.)
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Li ZH, Wang F, Zhang P, Xue P, Zhu SJ. Diagnosis and guidance of treatment of breast cancer cutaneous metastases by multiple needle biopsy: A case report. World J Clin Cases 2022; 10:345-352. [PMID: 35071538 PMCID: PMC8727255 DOI: 10.12998/wjcc.v10.i1.345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/16/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Breast cancer patients have a high skin metastasis rate. However, reports on treatment of cutaneous metastases of breast cancer are scarce.
CASE SUMMARY We report the treatment process for one breast cancer case with bone, lung, and skin metastases. The patient was a 43-year-old woman with advanced breast cancer and skin metastasis. She underwent pathological diagnosis by needle biopsy to guide the treatment. When the disease progressed, a new pathological diagnosis was determined by needle biopsy to guide the treatment. The patient received chemotherapy, endocrine therapy, and photodynamic dynamic therapy, followed by sonodynamic therapy.
CONCLUSION Repeated puncture should be performed for advanced breast cancer with skin metastasis, in order to obtain the pathology and directly determine diagnosis when the disease progresses. The treatment should focus on controlling the systemic metastasis, rather than the local disease.
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Affiliation(s)
- Zhong-Hui Li
- Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, Beijing Province, China
| | - Fang Wang
- Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, Beijing Province, China
| | - Ping Zhang
- Department of Pathology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, Beijing Province, China
| | - Peng Xue
- Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, Beijing Province, China
| | - Shi-Jie Zhu
- Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, Beijing Province, China
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27
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Duran J, Plaza JA. Update on Immunohistochemical Techniques in Dermatopathology. A focus on Adnexal Neoplasms. Semin Diagn Pathol 2022; 39:265-287. [DOI: 10.1053/j.semdp.2022.01.001] [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: 12/17/2021] [Revised: 12/22/2021] [Accepted: 01/07/2022] [Indexed: 11/11/2022]
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28
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Enechukwu N, Ifeanyi EO, Ogun GO, Ogunbiyi AO. Cutaneous metastases of embryonal rhabdomyosarcoma in a black African child: the role of dermoscopy in reducing time to and cost of diagnosis. Ecancermedicalscience 2021; 15:1304. [PMID: 34824627 PMCID: PMC8580718 DOI: 10.3332/ecancer.2021.1304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Indexed: 11/06/2022] Open
Abstract
Cutaneous metastases are an uncommon feature of solid organ malignancies. The cost of multiple investigations and prolonged processing time of biopsies may lead to diagnostic delays especially in resource limited practice settings. Dermoscopy can provide useful clues and has been found to be useful in the diagnosis of cutaneous metastases. Dermoscopic findings of skin lesions may limit unnecessary investigations and shorten time to diagnosis. There are limited data on dermoscopic features of embryonal rhabdomyosarcoma in the literature. We report dermoscopic features of cutaneous metastasis of embryonal rhabdomyosarcoma seen in a black African child.
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Affiliation(s)
- Nkechi Enechukwu
- Dermatology Unit, Department of Medicine, Nnamdi Azikiwe University/Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi 435101, Nigeria
| | - Ezejiofor Ogochukwu Ifeanyi
- Dermatology Unit, Department of Medicine, Nnamdi Azikiwe University/Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi 435101, Nigeria
| | - Gabriel Olabiyi Ogun
- Department of Pathology, College of Medicine, University of Ibadan, Ibadan 200212, Nigeria
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29
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Bulut E, Taştekin E, Topuz C, Öztürk S, Gökyer A. Exceptional Variant with Distant Cutaneous Metastasis as the First Clinical Sign in Gastric Signet-Ring Carcinoma. J Gastrointest Cancer 2021; 53:1135-1137. [PMID: 34786642 DOI: 10.1007/s12029-021-00747-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Skin metastases from gastric cancer are rare and usually occur very late in the course of the disease. The most common metastatic sites liver, the peritoneal surfaces, and the non regional or distant lymph nodes. CASE REPORT In this case we report the short-term survival of a 67-year-old man complined of multiple nodular lesions in various part of his skin. Histology showed a metastatic signet ring cell adenocarsinoma. Esophagogastroduodenoscopy was performed and a crater- like ulcer, about 3 cm in diameter, was observed on the anterior part of the stomach corpus distal. A biopsy specimen was obtained, and histopathological findings were consistent with gastric signet-ring cell carcinoma. XELOX chemotherapy regimen was initiated for the patient. CONCLUSION Skin metastasis of gastric adenocarcinoma is a rare condition with a poor prognosis. It may be the first manifestation of a clinically silent visceral cancer or may represent a recurrence of an internal malignancy.
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Affiliation(s)
- Ezgi Bulut
- Trakya University School of Medicine, Edirne, Turkey
| | - Ebru Taştekin
- Department of Pathology, Trakya University School of Medicine, Edirne, Turkey
| | - Canberk Topuz
- Department of Pathology, Trakya University School of Medicine, Edirne, Turkey
| | - Sevgi Öztürk
- Department of Dermatology, Çanakkale 18 Mart School of Medicine, Çanakkale, Turkey
| | - Ali Gökyer
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey.
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30
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Cutaneous Metastasis in a Previously Known Case of Ovarian Dysgerminoma: A Case Report. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2021. [DOI: 10.5812/ijcm.104715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Cutaneous metastasis is an uncommon manifestation that mostly occurs in patients with previous gastrointestinal or gynecological malignancies. Local recurrence usually can be seen in surgical incisions. Dysgerminomas are rare ovarian tumors that usually have local invasions, but metastases are infrequent. Here, we described a case of dysgerminoma and cutaneous metastasis in the surgical incision. Case Presentation: The patient was a 39-year-old woman previously known as ovarian dysgerminoma, who had undergone surgery one year ago. Ultrasound examination a year after surgery showed a 35 × 33 millimeters hypoechoic solid tumor in the left ovary and another 3 masses with similar echo pattern and vascularity were found in the surgical incision. Magnetic resonance imaging (MRI) findings were compatible with cutaneous metastasis of pervious dysgerminoma. Pathologic evaluation and Immunohistochemistry (IHC) confirmed dysgerminoma's skin metastasis. She received chemotherapy due to the recurrence of malignancy. Conclusions: Local recurrence and metastases (even in the skin) should be kept in mind and the clinician must examine the surgical site skin in patients with a history of malignancy.
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31
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Chen JW, Zheng LZ, Xu DH, Lin W. Extensive cutaneous metastasis of recurrent gastric cancer: A case report. World J Clin Cases 2021; 9:6575-6581. [PMID: 34435028 PMCID: PMC8362582 DOI: 10.12998/wjcc.v9.i22.6575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cutaneous metastasis is a rare event associated with poor prognosis for gastric cancer and has been rarely reported in the literature.
CASE SUMMARY A 69-year-old male patient who had undergone salvage gastrectomy and a few courses of adjuvant chemotherapy 3 mo earlier for recurrent gastric cancer developed widespread cutaneous metastases. Due to the patient’s intolerance to further adjuvant chemotherapy, he was placed in hospice care and expired 1 mo later. In the literature, gastric cancers are rarely reported as the primary malignancies for cutaneous metastasis. We, thus, provide an update on a case review published in 2014 by reviewing 10 more case reports dated from 2014 to 2020. The average age for the new group of patients was 59.4 ± 18.88-years-old. Thirty percent of the patients presented with cutaneous lesions and advanced gastric cancer synchronously while 70% developed cutaneous metastases 1.3 years to 14 years after the initial treatment for primary gastric cancer. Eighty percent of the patients received either local excision or chemo ± radiation therapy to treat their cutaneous metastases.
CONCLUSION This report highlights cutaneous metastasis as a late and untreatable metastasis of gastric cancer.
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Affiliation(s)
- Jun-Wei Chen
- Department of Clinical Medicine, The School of Clinical Medicine, Fujian Medical University, Fuzhou 350000, Fujian Province, China
- Department of Clinical Medicine, The Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
| | - Long-Zhi Zheng
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
| | - De-He Xu
- Department of Clinical Medicine, The School of Clinical Medicine, Fujian Medical University, Fuzhou 350000, Fujian Province, China
- Department of Clinical Medicine, The Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
| | - Wei Lin
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
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32
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Forest F, Laville D, Habougit C, Da Cruz V, Casteillo F, Yvorel V, Bard-Sorel S, Godard W, Picot T, Tiffet O, Perrot JL, Péoc'h M. Histopathologic and molecular profiling of lung adenocarcinoma skin metastases reveals specific features. Histopathology 2021; 79:1051-1060. [PMID: 34313338 DOI: 10.1111/his.14463] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/20/2021] [Accepted: 07/25/2021] [Indexed: 12/09/2022]
Abstract
AIMS Little is known regarding the histopathological and molecular features of lung adenocarcinoma skin metastases. Our study is the largest to comprehensively explore these to date. METHODS AND RESULTS We performed a retrospective cohort study analysing 42 lung adenocarcinoma skin metastasis samples obtained from a database of 2659 lung adenocarcinomas collected between 2010 to 2020. EGFR exon 19 deletion was detected in one patient, and KRAS mutations were detected in 12 (33.3%) patients. The PD-L1 tumour proportion score was <1% in 27 patients, ≥1% and <50% in 8 patients, ≥50% in 6 patients, and not assessable in one patient. We showed that the predominant histopathologic subtype is different from that at other metastatic sites (p=0.024). TTF-1 was more often negative in skin metastases compared to other sites (p<0.001). The EGFR mutation rate tended to be lower for skin metastases compared to other sites (p=0.079). Skin metastases were associated with a high rate of PD-L1-negative cases (p=0.022). CONCLUSION Our work shows that the skin metastases of lung adenocarcinoma have a specific histopathologic profile.
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Affiliation(s)
- Fabien Forest
- University Hospital of Saint Etienne. North Hospital, Department of Pathology, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France.,University Hospital of Saint Etienne. North Hospital, Plateforme de biologie moléculaire des tumeurs solides, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France.,Corneal Graft Biology, Engineering, and Imaging Laboratory, BiiGC, EA2521, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France
| | - David Laville
- University Hospital of Saint Etienne. North Hospital, Department of Pathology, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France
| | - Cyril Habougit
- University Hospital of Saint Etienne. North Hospital, Department of Pathology, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France
| | - Vanessa Da Cruz
- University Hospital of Saint Etienne. North Hospital, Department of Pathology, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France
| | - François Casteillo
- University Hospital of Saint Etienne. North Hospital, Department of Pathology, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France
| | - Violaine Yvorel
- University Hospital of Saint Etienne. North Hospital, Department of Pathology, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France.,University Hospital of Saint Etienne. North Hospital, Plateforme de biologie moléculaire des tumeurs solides, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France
| | | | - William Godard
- University Hospital of Saint Etienne. North Hospital, Department of Pathology, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France.,Institut de Pathologie du Forez, 11 Rue de la République, 42000, Saint-Étienne, France
| | - Tiphanie Picot
- University Hospital of Saint Etienne. North Hospital, Plateforme de biologie moléculaire des tumeurs solides, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France
| | - Olivier Tiffet
- University Hospital of Saint Etienne. North Hospital, Department of Thoracic Surgery, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France
| | - Jean-Luc Perrot
- University Hospital of Saint Etienne. North Hospital, Department of Dermatology, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France
| | - Michel Péoc'h
- University Hospital of Saint Etienne. North Hospital, Department of Pathology, Avenue Albert Raimond, 42055, Saint Etienne CEDEX 2, France
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33
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Li P, Barbieri A, Walther Z, McNiff J, Panse G. Epidermotropic metastasis of squamous cell carcinoma of the tonsil: A case report with molecular confirmation. J Cutan Pathol 2021; 48:1514-1519. [PMID: 34302376 DOI: 10.1111/cup.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 11/29/2022]
Abstract
Metastasis of oropharyngeal squamous cell carcinoma (SCC) to skin is uncommon and portends a poor prognosis. Clinical history and histopathology are key to discerning between metastatic disease vs de novo SCC of the skin. We describe a case of an HPV+ tonsillar SCC in a 77-year-old male, with metastasis to the neck skin. This case is unique because of prominent in situ epidermal involvement on skin biopsy specimen, complicating the distinction between primary and secondary disease. The nature of the lesion was resolved using next-generation sequencing of both the primary oropharyngeal SCC and skin lesion biopsy specimens. Both tumors showed identical ATR D1639G somatic mutations, while the skin lesion contained an additional POLE F1366L mutation. Clonal evolution of metastatic lesions is a well-described phenomenon; comparing the genetic profiles of primary and metastatic specimens can be useful in evaluating the tumor origin as well as identifying targetable genetic aberrations.
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Affiliation(s)
- Philippa Li
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Andrea Barbieri
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Zenta Walther
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jennifer McNiff
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Gauri Panse
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
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34
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Teyateeti P, Ungtrakul T. Retrospective review of cutaneous metastasis among 11,418 patients with solid malignancy: A tertiary cancer center experience. Medicine (Baltimore) 2021; 100:e26737. [PMID: 34398051 PMCID: PMC8294925 DOI: 10.1097/md.0000000000026737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 06/25/2021] [Indexed: 01/04/2023] Open
Abstract
Cutaneous metastasis (CM) occurs infrequently and usually presents during the later stages of cancer, and has a poor prognosis. Although there are insufficient current data, cancer treatment changes could have a positive impact on the outcome. This retrospective study aimed to review the pattern and prognosis of CM in patients with solid malignancy in a tertiary cancer center in Thailand.We reviewed the medical records of cancer patients diagnosed with CM between October 2009 and August 2015 at Chulabhorn Hospital, a tertiary cancer center in Thailand. Patients with primary skin cancer and hematological malignancies were excluded. We collected and analyzed data, including the time of cancer diagnosis and CM, type of cancer, clinical characteristics, and survival outcome.Of 11,418 patients, there were 33 (0.3%) were diagnosed with CM. Breast cancer was the most common primary cancer (12 cases, 36%). Skin nodules were commonly detected on the anterior chest wall. Also, 79% of CM patients had concomitant visceral metastasis. The median overall survival of those with CM was 9.21 months (95% confidence interval 4.75-83.38 months) regardless of presentation either at onset or disease recurrence (P = .083). However, the change of management was affected in 78% diagnosed with a later stage of CM. No statistical difference in survival was observed between breast cancer and non-breast cancer patients (8.79 vs 9.21 months, P = .613).Despite CM being a sign of poor prognosis, it may still be an indicator for changing cancer patients' treatment. Hence, early CM diagnosis and prompt novel therapy may positively affect outcomes for cancer patients.
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Affiliation(s)
- Phurichaya Teyateeti
- Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Teerapat Ungtrakul
- Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
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35
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DeCoste RC, Carter MD, Barnes PJ, Andea AA, Wang M, Rayson D, Walsh NM. Independent primary cutaneous and mammary apocrine carcinomas with neuroendocrine differentiation: Report of a case and literature review. J Cutan Pathol 2021; 48:1397-1403. [PMID: 34152024 DOI: 10.1111/cup.14085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/25/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Abstract
Cutaneous apocrine carcinomas share common features with their counterparts in the breast; hence, metastatic mammary carcinoma must be excluded before such lesions can be designated primary cutaneous neoplasms. Primary tumors from either source rarely exhibit neuroendocrine differentiation. We report a case of a 72-year-old female with a painless 1.2-cm scalp nodule. An incisional biopsy revealed dermal involvement by an invasive apocrine carcinoma juxtaposed to a benign apocrine cystic lesion. Immunohistochemically, the carcinoma expressed neuroendocrine proteins including synaptophysin, chromogranin, and CD56. A primary cutaneous apocrine carcinoma with neuroendocrine differentiation was favored, but additional investigations to exclude breast origin were recommended. These revealed a 1.1-cm nodule in the right breast, which proved to be an invasive ductal carcinoma, morphologically and immunophenotypically similar to the scalp lesion. This confounded the case, yet factors militating against metastatic breast carcinoma to skin included (a) the small size of the mammary tumor, (b) absence of other metastatic disease, and (c) juxtaposition of the scalp carcinoma to a putative benign precursor. Molecular studies were undertaken to resolve the diagnostic quandary. Single nucleotide polymorphism microarray analysis revealed distinct patterns of chromosomal copy number alterations in the two tumors, supporting the concept of synchronous and unusual primary neoplasms.
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Affiliation(s)
- Ryan C DeCoste
- Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Michael D Carter
- Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Penelope J Barnes
- Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Aleodor A Andea
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Min Wang
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniel Rayson
- Division of Medical Oncology and Department of Medicine, Nova Scotia Health Authority (Central Zone) and Dalhousie University, Halifax, Nova Scotia, Canada
| | - Noreen M Walsh
- Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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36
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Cazzato G, Colagrande A, Cimmino A, De Marco A, Romita P, Foti C, Resta L, Ingravallo G. Cutaneous Metastases from Primary Liver Cancers: The Need for Knowledge and Differential Diagnosis. Life (Basel) 2021; 11:life11060559. [PMID: 34198568 PMCID: PMC8231899 DOI: 10.3390/life11060559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/31/2021] [Accepted: 06/12/2021] [Indexed: 02/06/2023] Open
Abstract
Primary skin tumors are certainly more frequent than metastatic tumors, but the latter can sometimes be the first sign of otherwise unrecognized neoplastic pathology and always correspond to an advanced stage of the disease. Among the various neoplasms that can metastasize in cutaneous districts, skin metastases from primary malignant neoplasms from the liver and biliary tract are infrequent, and when they do occur they can pose differential diagnosis problems to the pathologist. Here we present two cases of metastatic skin lesions, respectively originating from the liver and the intrahepatic biliary tract, and we conduct a brief review of the current literature.
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Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-3405203641 (G.C.)
| | - Anna Colagrande
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
| | - Antonietta Cimmino
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
| | - Aurora De Marco
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.M.); (P.R.); (C.F.)
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.M.); (P.R.); (C.F.)
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.M.); (P.R.); (C.F.)
| | - Leonardo Resta
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-3405203641 (G.C.)
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Fukui Y, Kubo N, Sakurai K, Tamamori Y, Maeda K, Ohira M. Metachronous port site, muscular and subcutaneous metastases from a gastric adenocarcinoma: a case report and review of articles. Surg Case Rep 2021; 7:124. [PMID: 34013476 PMCID: PMC8134604 DOI: 10.1186/s40792-021-01202-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 05/05/2021] [Indexed: 12/20/2022] Open
Abstract
Background Port site metastasis (PSM) after curative gastrectomy for gastric cancer and muscular metastasis from gastric cancer are rare manifestations. Similarly, subcutaneous metastasis from gastric cancer is rare, and muscular and subcutaneous metastases are associated with poor prognosis. We report a case of long-term survival in a patient who underwent curative resection of gastric cancer and repeated recurrence of port site, muscular and subcutaneous metastases from gastric cancer, treated by resection. Case presentation A 75-year-old man was diagnosed with gastric cancer and referred to our department. Upper endoscopy demonstrated a 5-cm circumferential ulcerated lesion at the cardia. Biopsy findings showed a poorly differentiated tubular adenocarcinoma. He underwent laparoscopic total gastrectomy with lymph node dissection, and pathologic examination revealed a moderately differentiated tubular adenocarcinoma stage T4aN1M0 and IIIA according to the UICC (Union for International Cancer Control) classification. He refused adjuvant chemotherapy and was only carefully observed. Twenty-three months after the primary gastrectomy, computed tomography (CT) revealed an irregular mass near the port site wounds. Then the patient underwent mass resection, and the pathological diagnosis was consistent with metastatic adenocarcinoma, located in the subcutaneous tissue at the port site wounds. Thirteen months after the second surgery, CT revealed an enhanced mass in the abdominal wall. Positron emission tomography (PET) CT showed an elevated uptake in the rectus abdominis muscle and a standardized uptake value (SUV) of 3.1. The patient underwent another mass resection, and the pathological diagnosis was consistent with metastatic adenocarcinoma in the rectus abdominis muscle. Thirty-five months after the third surgery, CT revealed a mass in the left gluteal subcutaneous region. Furthermore, PET-CT revealed a 35-mm mass with an elevated SUV of 9.6. Another mass resection procedure was performed, and the pathological diagnosis was consistent with metastatic adenocarcinoma in the subcutaneous tissue. Since tumor cells were present at the resection margin, additional radiation therapy was performed. The patient has survived 78 months after primary gastrectomy. Conclusion The prognosis of muscular and subcutaneous metastases from gastric cancer is poor. However, if the metastatic tumor is solitary, surgical excision could be a feasible treatment option and might prolong survival.
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Affiliation(s)
- Yasuhiro Fukui
- Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori Miyakojima-ku, Osaka City, Osaka, 534-0021, Japan.
| | - Naoshi Kubo
- Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori Miyakojima-ku, Osaka City, Osaka, 534-0021, Japan
| | - Katsunobu Sakurai
- Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori Miyakojima-ku, Osaka City, Osaka, 534-0021, Japan
| | - Yutaka Tamamori
- Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori Miyakojima-ku, Osaka City, Osaka, 534-0021, Japan
| | - Kiyoshi Maeda
- Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori Miyakojima-ku, Osaka City, Osaka, 534-0021, Japan
| | - Masaichi Ohira
- Department of Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka, 545-8585, Japan
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Tollan CJ, Moyes C, Malyon A. Rare cutaneous metastasis from sarcomatoid carcinoma of lung. BMJ Case Rep 2021; 14:14/3/e240731. [PMID: 33692067 PMCID: PMC7949380 DOI: 10.1136/bcr-2020-240731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We present the case of a 57-year-old woman diagnosed with stage 4 sarcomatoid carcinoma of the lung who concurrently developed a scalp lesion, thought to be a cyst, which continued to grow and ulcerate. Excision revealed a rare case, only four previously reported in the literature, of metastatic sarcomatoid carcinoma of the lung. While a very unusual case, we would like to emphasise the importance of considering skin metastases when presented with unusual skin lesions, and importantly listening to the patient's concerns, showing empathy and respecting their autonomy and referring to an appropriate specialist when considering the management of what may seem to be a minor skin report.
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Affiliation(s)
| | - Colin Moyes
- Pathology Department, Forth Valley Royal Hospital, Larbert, Falkirk, UK
| | - Andrew Malyon
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, Scotland, UK
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Şahin M, Ekinci F, Çelik C, Temiz P, Erdoğan AP, Göksel G. A Rare Case Report of Skin Metastasis in Gastric Cancer. J Gastrointest Cancer 2021; 52:1156-1158. [PMID: 33635503 DOI: 10.1007/s12029-021-00603-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Mustafa Şahin
- Internal Medicine Department, Celal Bayar University, Manisa, Turkey.
| | - Ferhat Ekinci
- Medical Oncology Department, Celal Bayar University, Manisa, Turkey
| | - Cumali Çelik
- Medical Oncology Department, Celal Bayar University, Manisa, Turkey
| | - Peyker Temiz
- Medical Pathology Department, Celal Bayar University, Manisa, Turkey
| | | | - Gamze Göksel
- Medical Oncology Department, Celal Bayar University, Manisa, Turkey
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40
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Wang X, Wang H, Jia B, He F, Yuan Y, Zhang W. Cutaneous Metastasis as the First Presentation of Non-Small-Cell Lung Cancer with a BRAF Mutation: A Case Report. Onco Targets Ther 2021; 13:13143-13149. [PMID: 33380804 PMCID: PMC7767729 DOI: 10.2147/ott.s282593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/03/2020] [Indexed: 11/23/2022] Open
Abstract
Cutaneous metastasis from a primary visceral malignancy is a relatively uncommon clinical manifestation that occurs as an initial presentation in 1% to 12% of patients with internal malignancies. Additionally, cutaneous metastases are often late signs of an internal malignancy, and in very rare cases they may occur at the same time or before the primary cancer has been detected. Metastasis to the skin has a poor prognosis and is often a sign of widespread malignant tumors. In the present study, we report a 72-year-old male who presented with multiple rapidly growing subcutaneous nodules. Positron emission tomography-computed tomography (PET-CT) revealed a hypermetabolic concentration of radiotracer in the left lower lung and multiple organ metastases associated with multiple skin masses. Biopsy of one of the skin nodules and gene detection indicated metastatic adenocarcinoma consistent with a primary lung origin with a BRAF mutation. BRAF mutations are emerging therapeutic targets in non-small-cell lung cancer (NSCLC), as they are present in 2–4% of NSCLC cases. To the best of our knowledge, this is the first case report to show that BRAF-mutant lung adenocarcinoma can be associated with cutaneous metastasis. Early diagnosis and individualized treatment strategies may prolong patient survival.
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Affiliation(s)
- Xuejun Wang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Hongmei Wang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Baochang Jia
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Fang He
- Department of Radiation Oncology, Zhongshan City People's Hospital, Zhongshan, Guangdong Province, People's Republic of China
| | - Yawei Yuan
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Weijun Zhang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
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Cutaneous Metastases in a Patient With Muir-Torre Syndrome. Dermatol Surg 2021; 47:129-131. [PMID: 31567488 DOI: 10.1097/dss.0000000000002158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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42
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Kapatia G, Sahu S, Rohilla M, Gupta P, Gupta N, Srinivasan R, Rajwanshi A, Dey P. Clinical and morphological spectrum of cutaneous metastases on cytology: A study of 225 cases. Cytopathology 2020; 32:233-237. [PMID: 33128312 DOI: 10.1111/cyt.12934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Any type of cutaneous metastasis indicates dismal outcome of the disease. Skin is an unusual location for metastatic deposits from any tumour and has an incidence of about 0.8%-5%. Fine needle aspiration cytology (FNAC) helps in the rapid diagnosis of metastasis with minimum pain. AIM To study the cytomorphological spectrum of cutaneous metastasis on FNAC. MATERIAL AND METHODS A total of 225 patients with diagnosis of cutaneous metastasis on cytology were analysed. May-Grünwald Giemsa and haematoxylin-eosin-stained smears were studied and examined for the cytomorphological spectrum of cutaneous metastasis. Cell block was prepared in a few cases. In a subset of cases, immunohistochemistry was done to pinpoint the primary. RESULTS Amongst the 225 patients studied, the mean age was 53.9 years. There was female preponderance with 125 females and 100 males. The commonest site was abdominal wall (n = 89) followed by chest wall (n = 60). The most common type of metastasising tumour was adenocarcinoma. CONCLUSION Clinicians and pathologists must be aware of the clinico-morphological spectrum of cutaneous metastasis for instant diagnosis followed by prompt management.
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Affiliation(s)
- Gargi Kapatia
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Saumya Sahu
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Manish Rohilla
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Nalini Gupta
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Pranab Dey
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
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43
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Yasokawa N, Yasuda Y, Chin H, Kurose K, Aoyama Y, Oga T. Generalized herpes zoster and cutaneous metastasis during chemotherapy for non-small cell lung cancer: A case report. Thorac Cancer 2020; 12:117-121. [PMID: 33118287 PMCID: PMC7779188 DOI: 10.1111/1759-7714.13722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 01/05/2023] Open
Abstract
Although herpes zoster is known to occur in some patients with lung cancer, generalized (disseminated) herpes zoster is an uncommon form whereby hematogenous dissemination of the virus occurs and leads to the development of widespread cutaneous lesions. Similarly, skin is an uncommon site of metastasis in patients with lung cancer. Here, we report a clinical case of a 53‐year‐old male patient who developed generalized herpes zoster during chemotherapy for non‐small cell lung cancer (squamous cell carcinoma) and subsequently developed cutaneous metastasis of lung cancer after generalized herpes zoster was cured by treatment with intravenous aciclovir. The coincidence of these two conditions, generalized herpes zoster and cutaneous metastasis, in the patient during lung cancer treatment might be associated with an impaired or dysregulated immune system partly due to repeated chemotherapy, indicating a poor prognosis. Close observation and accurate diagnosis of changes in the skin of patients with lung cancer are important when evaluating their immune status and considering their therapy and prognosis.
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Affiliation(s)
- Naoya Yasokawa
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Yuri Yasuda
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Houhi Chin
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Koji Kurose
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Yumi Aoyama
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Toru Oga
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
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44
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Hastings V, McEachron J, Kanis MJ. Cutaneous metastasis of PD-L1 positive ovarian carcinoma. Gynecol Oncol Rep 2020; 33:100607. [PMID: 32671171 PMCID: PMC7339030 DOI: 10.1016/j.gore.2020.100607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/17/2020] [Accepted: 06/27/2020] [Indexed: 12/02/2022] Open
Abstract
Ovarian cancer (OC) metastasizes cutaneous in up to 6% of cases. Cutaneous metastasis to the vulva is rare; with only one prior report in the literature. Resection of cutaneous metastasis offers symptom relief as well as a potential survival benefit. Molecular tumor profiling should be employed to expand therapy options.
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Affiliation(s)
- Victoria Hastings
- Division of Gynecologic Oncology, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, NY, United States
| | - Jennifer McEachron
- Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Marguax J Kanis
- Division of Gynecologic Oncology, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, NY, United States
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45
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Ríos-Viñuela E, Bernia E, Diago A, Requena L, Traves V, Requena C. A unilateral zosteriform cutaneous eruption on the lower extremity. Int J Dermatol 2020; 60:e137-e139. [PMID: 32496581 DOI: 10.1111/ijd.14980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Elisa Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Eduardo Bernia
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Adrián Diago
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Madrid, Spain
| | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
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46
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Padden S, Abraham E, Viscosi E, Habin K, Lundquist D. Cutaneous Metastases: A Case Study on Clinical Care for Patients. Clin J Oncol Nurs 2020; 24:320-323. [DOI: 10.1188/20.cjon.320-323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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47
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Nandwani M, Barmon D, Begum D, Kataki AC. Rare Sites Metastasis in Ovarian Carcinoma: a Compilation of 3 Case Reports. Indian J Surg Oncol 2020; 11:150-153. [DOI: 10.1007/s13193-019-00988-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 09/25/2019] [Indexed: 11/28/2022] Open
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48
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Salari B, Sheinbein DM, Rosman IS, Dehner LP. Metastatic pancreatic adenosquamous carcinoma to the scalp: A case report and review of the literature. J Cutan Pathol 2020; 47:263-268. [PMID: 31587324 DOI: 10.1111/cup.13582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 12/30/2022]
Abstract
Metastatic carcinoma to the skin occurs in only a minority of patients with a visceral or internal malignancy, with breast, lung, and colorectum accounting for the majority of cases. We present the case of a 66-year-old man with a recent violaceous nodule of the left scalp (1.2 × 1.0 × 0.2 cm) that was a metastatic pancreatic adenosquamous carcinoma, representing a seemingly rare event. Two months prior, after complaining of right hip pain, an image revealed a right femoral lesion. A biopsy of that lesion showed moderately differentiated adenocarcinoma. Subsequent imaging showed a mass in the pancreatic tail and also markedly elevated serum tumor markers, CA 19-9 and carcinoembryonic antigen (5325 and 111.5 U/mL, respectively). Before the appearance of the scalp nodule, the patient received radiotherapy and was started on chemotherapy, which was continued after diagnosis and resection of the nodule. Subsequent metastases developed in the liver, lung and additional cutaneous lesions. He died 11 months after initial presentation with right hip pain. As this case shows, cutaneous metastases confer a poor prognosis, often with less than a year survival following their appearance.
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Affiliation(s)
- Behzad Salari
- Lauren V. Ackerman Laboratory of Surgical Pathology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
| | - David M Sheinbein
- Division of Dermatology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
| | - Ilana S Rosman
- Lauren V. Ackerman Laboratory of Surgical Pathology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
- Division of Dermatology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
| | - Louis P Dehner
- Lauren V. Ackerman Laboratory of Surgical Pathology, School of Medicine, Washington University Medical Center, St. Louis, Missouri
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Mandzhieva B, Jalil A, Nadeem M, Hasan SA, Jain AG. Most Common Pathway of Metastasis of Rectal Signet Ring Cell Carcinoma to the Skin: Hematogenous. Cureus 2020; 12:e6890. [PMID: 32190453 PMCID: PMC7058390 DOI: 10.7759/cureus.6890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Liver represents the most common site of metastasis in patients with advanced colorectal cancer (CRC). Cutaneous metastasis is uncommon and has been documented only in 3% of patients. Most cutaneous metastases demonstrate typical histological features of adenocarcinoma, such as glandular formation and mucin production. We present the case of a 66-year-old male with Crohn's disease (CD) and stage IV rectal signet ring cell carcinoma arising in his rectal stump who presented with a painful papular bilateral groin rash. Biopsy revealed metastatic signet ring cell carcinoma. Since cutaneous metastasis in patients with advanced CRC can be easily confused with infection, especially fungal infection, physicians should be vigilant of the possibility of cutaneous metastasis. Our literature review suggests hematogenous spread as the dissemination pathway of this histological subtype of rectal adenocarcinoma to the skin. We present the first case of cutaneous metastatic signet ring cell carcinoma from a rectal stump of a patient with CD.
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Affiliation(s)
| | - Anum Jalil
- Internal Medicine, AdventHealth, Orlando, USA
| | - Mahum Nadeem
- Internal Medicine, University of Oklahoma, Oklahoma City, USA
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50
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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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