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Gschnell M, Volberg C, Hauser C, Krönig L. Cutaneous metastases: From epidemiology to therapy. J Dtsch Dermatol Ges 2024; 22:974-993. [PMID: 38888379 DOI: 10.1111/ddg.15342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 11/20/2023] [Indexed: 06/20/2024]
Abstract
Cutaneous metastases are seen in up to 10% of all oncology patients and can occur in different locations depending on the entity. Cutaneous metastases are often associated with a high psychological burden and, especially in the case of exulceration, with shame and social withdrawal. This review discusses the diagnostic and therapeutic options. The most common tumor entities in which cutaneous metastases are observed are discussed, and local and systemic treatment options are presented according to the current state of research.
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Affiliation(s)
- Martin Gschnell
- Department of Dermatology and Allergology, University Hospital of Marburg, Philipps University Marburg, Marburg, Germany
| | - Christian Volberg
- Department of Anesthesia and Intensive Care, University Hospital of Marburg, Philipps University Marburg, Marburg, Germany
- Research Group Medical Ethics, Department of Human Medicine, Philipps University Marburg, Marburg, Germany
| | - Christina Hauser
- Department of Dermatology and Allergology, University Hospital of Marburg, Philipps University Marburg, Marburg, Germany
| | - Lisa Krönig
- Department of Dermatology and Allergology, University Hospital of Marburg, Philipps University Marburg, Marburg, Germany
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2
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Irvine J, McKenna L, Wylie G. Cutaneous metastases as the presenting feature of lung cancer. BMJ Case Rep 2023; 16:e255225. [PMID: 38142053 DOI: 10.1136/bcr-2023-255225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2023] Open
Abstract
Lung cancer is the second most common cancer diagnosed in men and women worldwide with the highest mortality. A rare site of metastases for lung cancer is the skin. Typically, the diagnosis is secure prior to developing cutaneous metastases. We present a case of a man in his mid-70s who presented to dermatology with cutaneous metastases. We outline the presentation, diagnostic workup and management of this case. We also review the literature of cutaneous metastases in lung cancer; highlighting the clinical need for a timely accurate diagnosis and the implication in terms of prognosis.
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Affiliation(s)
- James Irvine
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Louise McKenna
- Dermatology Department, Queen Elizabeth University Hospital, Glasgow, UK
| | - Grant Wylie
- Dermatology Department, Queen Elizabeth University Hospital, Glasgow, UK
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3
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Hasnaoui A, Trigui R, Benasr A, Nouira M, Ben Abdallah F. Invasive mucinous adenocarcinoma of the lung revealed by a subcutaneous metastasis: A case report of a rare presentation. Int J Surg Case Rep 2023; 112:108964. [PMID: 37862772 PMCID: PMC10667891 DOI: 10.1016/j.ijscr.2023.108964] [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: 09/28/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/22/2023] Open
Abstract
INTRODUCTION Lung cancer stands as the second most prevalent tumour and the foremost cause of cancer-related mortality. It typically manifests through respiratory symptoms. Subcutaneous metastases originating from pulmonary cancers are rare occurrences, with a remarkably low incidence. PRESENTATION OF CASE A 53-year-old patient, with a history of smoking and unchecked chronic obstructive pulmonary disease, sought care at our outpatient clinic due to the rapid development of a subcutaneous mass. The patient underwent surgical excision of the mass under local anaesthesia. The anatomopathological examination confirmed the diagnosis of cutaneous metastasis from an infiltrative adenocarcinoma. A whole-body CT scan revealed an invasive mucinous adenocarcinoma of the lung. Consequently, palliative chemotherapy was initiated. Unfortunately, the patient succumbed to the disease three months later. DISCUSSION Subcutaneous metastasis originating from pulmonary sources is a rare phenomenon, with scant literature available on the subject. The presence of pulmonary cutaneous metastasis serves as an ominous sign of rapidly progressing and aggressive lung cancer. The prognosis in such cases is reserved, with an overall survival rate measured in months. The approach to management in these instances predominantly revolves around palliative chemotherapy, although surgical excision of metastases may be considered in select cases. CONCLUSION Lung cancer unmasked by subcutaneous metastasis represents a rare clinical scenario. While chemotherapy remains the cornerstone of treatment, surgical intervention to remove metastases may be contemplated in a restricted subset of cases. Further research is imperative to ascertain the impact of surgery on both quality of life and overall survival.
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Affiliation(s)
- Anis Hasnaoui
- Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar 1006, Tunis, Tunisia; Department of General Surgery, Menzel Bourguiba hospital, Tunisia.
| | - Racem Trigui
- Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar 1006, Tunis, Tunisia; Department of General Surgery, Menzel Bourguiba hospital, Tunisia
| | - Amal Benasr
- Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar 1006, Tunis, Tunisia; Department of General Surgery, Menzel Bourguiba hospital, Tunisia.
| | - Mariem Nouira
- Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar 1006, Tunis, Tunisia; Department of epidemiology, Menzel Bourguiba hospital, Tunisia
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4
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Zhang L, Wang J, Yang S, Lu L, Yu X. Nasal Alar and Scalp Metastases From Lung Carcinoma: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023:1455613231177984. [PMID: 37264890 DOI: 10.1177/01455613231177984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Both nasal alar and scalp metastases from lung carcinoma are exceedingly rare. Herein, we report a case of an elderly male smoker who had left lung carcinoma and underwent radical resection. Seven months later, masses began to appear on his nasal alar and parietal scalp which gradually increased in size. The nasal computed tomography and head magnetic resonance imaging scan revealed a dense soft tissue shadow in the right nasal alar and nasal cavity, as well as a soft tissue nodule in the middle of the parietal scalp. A biopsy was performed and immunohistochemistry suggested poorly differentiated metastatic carcinoma that was consistent with the characteristics of primary lung carcinoma and supported the diagnosis of nasal alar and scalp metastases. Then, he received a combined treatment of Albumin paclitaxel and Xindirizumab. However, he passed away 3 months later. In addition to this case, we also review the clinical features of nose and/or scalp metastases from lung carcinoma based on previously reported cases as well as this case.
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Affiliation(s)
- Lu Zhang
- Department of Otorhinolaryngology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China
| | - Jiyun Wang
- Department of Otorhinolaryngology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China
| | - Sijia Yang
- Department of Respiratory Medicine, Ningbo No.2 Hospital, Ningbo, Zhejiang, China
| | - Lu Lu
- Ningbo Clinical Pathology Diagnosis Center, Ningbo, Zhejiang, China
| | - Xiao Yu
- Department of Otorhinolaryngology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China
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5
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Natal R, Oliveira M, Amaral A, Cabral F, Gomes R, Ferreira L. A survival analysis of cutaneous metastases in lung cancer: A 25-year experience. PNEUMON 2022. [DOI: 10.18332/pne/155918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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6
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Kim HK, Kang SH, Kim WS, Kang SH, Kim WJ, Kim HS, Bae TH. Scalp metastasis from an adenocarcinoma of the lung mimicking a cystic mass: case report and literature review. Arch Craniofac Surg 2022; 23:237-240. [PMID: 36373259 PMCID: PMC9663264 DOI: 10.7181/acfs.2022.00892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/04/2023] Open
Abstract
A 67-year-old man visited our plastic surgery clinic complaining of a palpable protruding mass (2.0 × 2.5 cm) in the right occipital region. To establish an appropriate treatment plan for the cystic mass, brain magnetic resonance imaging was performed. A 2.2 cm nodular lesion with peripheral enhancement in the right occipital region of the scalp was confirmed. In addition, two rim-enhancing nodular lesions up to 9 mm with marked perilesional edema in the right frontal lobe were confirmed. The findings suggested metastasis from cancer. After further evaluations, a mass in the right lower lung field was identified as adenocarcinoma of the lung. Histological examination characterized the excised lesion as a cutaneous metastasis from lung adenocarcinoma. This case report shows that a cystic mass, which commonly occurs in the scalp, may indicate lung cancer. In particular, if a cystic mass of the scalp is identified in a person at high risk for lung cancer, appropriate evaluation and urgent treatment should be performed.
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Affiliation(s)
- Han Koo Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Seung Hyun Kang
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Woo Seob Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Shin Hyuk Kang
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Woo Ju Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong,
Korea
| | - Hyeon Seok Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Tae Hui Bae
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong,
Korea
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7
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Chisenga R, Adenwala T, Kim W, Mujuni D, Samuel R. Squamous cell carcinoma of the lung presenting as a fungating ulcerated skin lesion: a case report. J Med Case Rep 2022; 16:172. [PMID: 35468849 PMCID: PMC9040228 DOI: 10.1186/s13256-022-03352-4] [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: 11/01/2021] [Accepted: 03/01/2022] [Indexed: 11/22/2022] Open
Abstract
Background Our patient presents with a novel presentation of a fungated ulcerated skin lesion as the initial presentation of lung cancer. The literature describes skin metastases from lung cancer as nodular, papular, and zosteriform. Our case is a fungating ulcerated skin lesion which is not widely reported in literature. There is a still a need for more data on the clinical presentation and prognosis of such cases as it will elucidate the diagnostic challenges and treatment management. Case presentation We present a case of a 55 year old Caucasian male with a 60-pack-year smoking history initially presenting with a nodule on his right upper back that quickly fungated and ulcerated requiring surgical excision. Biopsy of both the skin lesion and the lung mass confirmed squamous cell carcinoma (SCC) and the lung mass being the primary tumor. The patient’s clinical and functional status severely declined during his hospital stay and was later discharged to hospice without therapeutic intervention. He later expired a month after hospice stay. Conclusions Although uncommon, this case clearly illustrates that skin metastases can be the initial finding of primary lung cancer and that not all patients with lung cancer will present with bronchopulmonary symptoms. It also illustrates that a fungating ulcerated lesion can be the initial presentation of lung cancer in addition to nodular, papular, and zosteriform presentations noted in the literature.
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Affiliation(s)
- Rose Chisenga
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Tasneem Adenwala
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - William Kim
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
| | - Daniel Mujuni
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Rachel Samuel
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
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8
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Bolewska A, Słowińska M, Błońska A, Ceryn J, Grala B, Narbutt J, Ciążyńska M, Małecki W, Skibińska M, Lesiak A, Paluchowska E, Owczarek W. Tumor of the Nose - A Rare Manifestation of a Metastatic Lung Cancer. Clin Cosmet Investig Dermatol 2021; 14:1311-1318. [PMID: 34584435 PMCID: PMC8464336 DOI: 10.2147/ccid.s318748] [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: 05/27/2021] [Accepted: 08/05/2021] [Indexed: 12/14/2022]
Abstract
Lung cancer most often metastasizes to the central nervous system, bone and liver. Although metastases to the skin are quite rare, it is estimated that they may be the first clinical manifestation of this disease in 0.7%–12% of cases. Metastases to the skin are caused by adenocarcinoma (about 30%), squamous cell carcinoma (30%) and undifferentiated carcinoma (40%). Nasal tip metastases are extremely rare. They can be confused with more common skin problems, including non-melanoma skin cancers, rhinophyma, inflammatory tumors or infectious diseases. We report two patients with a tumor on the nose, which proved to be the first sign of the metastatic lung cancer.
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Affiliation(s)
| | - Monika Słowińska
- Department of Dermatology, Military Institute of Medicine, Warsaw, Poland
| | - Agata Błońska
- Department of Dermatology, Military Institute of Medicine, Warsaw, Poland
| | - Justyna Ceryn
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Łódź, Poland
| | - Bartłomiej Grala
- Department of Pathology, Military Institute of Medicine, Warsaw, Poland
| | - Joanna Narbutt
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Łódź, Poland
| | - Magdalena Ciążyńska
- Department of Proliferative Diseases, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, Łódź, Poland
| | - Wojciech Małecki
- Department of Clinical Oncology and Chemotherapy, Poddębice Health Centre, Poddębice, Poland
| | - Małgorzata Skibińska
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Łódź, Poland
| | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Łódź, Poland
| | - Elwira Paluchowska
- Department of Dermatology, Military Institute of Medicine, Warsaw, Poland
| | - Witold Owczarek
- Department of Dermatology, Military Institute of Medicine, Warsaw, Poland
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9
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Tvedten E, Deak Z, Schwartz B, Rice A. An Atypical Presentation of Soft Tissue Metastasis in a Patient With Lung Cancer. Cureus 2021; 13:e16294. [PMID: 34405061 PMCID: PMC8352797 DOI: 10.7759/cureus.16294] [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] [Accepted: 07/10/2021] [Indexed: 11/27/2022] Open
Abstract
Soft tissue metastasis in patients with lung cancer is infrequently reported in the literature. Primary lung carcinomas have been shown to exhibit evidence of metastasis to soft tissue in 2.3% of cases. A 75-year-old Caucasian female presented with clinical signs of anemia and the appearance of several soft tissue masses on her back. The patient was a former smoker with a 20-pack-year history. Further workup revealed a diagnosis of adenocarcinoma of the lung with soft tissue metastasis. Recognizing the early signs of metastasis is crucial to providing the patient the best treatment available, and the importance of a thorough physical examination cannot be emphasized enough.
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Affiliation(s)
- Erika Tvedten
- General Surgery, Detroit Medical Center Sinai-Grace Hospital, Detroit, USA
| | - Zachary Deak
- General Surgery, Detroit Medical Center Sinai-Grace Hospital, Detroit, USA
| | - Beth Schwartz
- General Surgery, Detroit Medical Center Sinai-Grace Hospital, Detroit, USA
| | - Ashlee Rice
- General Surgery, Detroit Medical Center Sinai-Grace Hospital, Detroit, USA
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10
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Sharma G, Kumar P, Veerwal H, Singh P, Gupta S, Dhingra V. Cutaneous Metastases as Initial Presentation of Lung Carcinoma. Cureus 2021; 13:e15344. [PMID: 34235022 PMCID: PMC8243388 DOI: 10.7759/cureus.15344] [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] [Accepted: 05/31/2021] [Indexed: 11/25/2022] Open
Abstract
Breast cancer, in women, and lung cancer, in men, are the most common origins of cutaneous metastasis. Lung cancer can metastasize to any organ but mostly to the contralateral lung, liver, adrenal gland, bones, and brain. Over 1-12% of patients with lung cancer can develop skin metastasis. Non-small cell lung cancer includes 87% of lung cancer cases. Adenocarcinomas subtype accounts for approximately 40% of all lung cancers and is the most common histology in women. A woman’s lifetime risk of developing lung cancer is 1 in 16 women but lower than that of a man (1 in 13 men). The survival rates of women with lung cancer are usually higher than those of men. Herein, we report the case of a 66-year-old female who presented with painless multiple skin nodules over the chest back and axilla for three months. On evaluation, biopsy and immunohistochemistry were done from skin nodules suggestive of adenocarcinoma. CT thorax showed lung mass and was diagnosed as a case of metastatic adenocarcinoma, primary being from the lung. Our case demonstrated that skin metastasis could be the first sign of internal malignancy. Metastasis to the skin is often a preterminal event that heralds a poor prognosis.
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Affiliation(s)
- Gaurav Sharma
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Pramit Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Hardik Veerwal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Vandana Dhingra
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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11
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Primary skin manifestation of non-small-cell lung cancer - a case study. Postepy Dermatol Alergol 2019; 36:369-370. [PMID: 31333356 PMCID: PMC6640010 DOI: 10.5114/ada.2018.73428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 01/08/2018] [Indexed: 12/19/2022] Open
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12
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Gupta N, Malik D, Verma R, Belho ES, Manocha A. Cutaneous Metastasis from Visceral Organs: 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography Scan Aiding in Localizing Primary Site. Indian J Nucl Med 2019; 34:205-208. [PMID: 31293299 PMCID: PMC6593935 DOI: 10.4103/ijnm.ijnm_66_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Skin metastases are rare from systemic malignancy, and incidence reported is between 0.7% and 9% in various malignancies and usually occur in advanced stage. Here, we report three cases, one each of carcinoma esophagus, carcinoma breast, and carcinoma lung, where patients presented with metastatic cutaneous lesions and positron-emission tomography-computed tomography (PET-CT) scan whole body helped in localizing the primary site. Whole-body fluorodeoxyglucose PET-CT scan helps in scanning whole body at once and detect occult primary and metastatic sites.
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Affiliation(s)
- Nitin Gupta
- Department of Nuclear Medicine and PET/CT, Centre for Advanced Research in Imaging, Neuroscience and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Dharmender Malik
- Department of Nuclear Medicine and PET/CT, Centre for Advanced Research in Imaging, Neuroscience and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Ritu Verma
- Department of Nuclear Medicine and PET/CT, Centre for Advanced Research in Imaging, Neuroscience and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Ethel Shangne Belho
- Department of Nuclear Medicine and PET/CT, Centre for Advanced Research in Imaging, Neuroscience and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Anisha Manocha
- Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India
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14
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Kühlbach C, da Luz S, Baganz F, Hass VC, Mueller MM. A Microfluidic System for the Investigation of Tumor Cell Extravasation. Bioengineering (Basel) 2018; 5:E40. [PMID: 29882894 PMCID: PMC6027408 DOI: 10.3390/bioengineering5020040] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/17/2018] [Accepted: 05/21/2018] [Indexed: 01/05/2023] Open
Abstract
Metastatic dissemination of cancer cells is a very complex process. It includes the intravasation of cells into the metastatic pathways, their passive distribution within the blood or lymph flow, and their extravasation into the surrounding tissue. Crucial steps during extravasation are the adhesion of the tumor cells to the endothelium and their transendothelial migration. However, the molecular mechanisms that are underlying this process are still not fully understood. Novel three dimensional (3D) models for research on the metastatic cascade include the use of microfluidic devices. Different from two dimensional (2D) models, these devices take cell⁻cell, structural, and mechanical interactions into account. Here we introduce a new microfluidic device in order to study tumor extravasation. The device consists of three different parts, containing two microfluidic channels and a porous membrane sandwiched in between them. A smaller channel together with the membrane represents the vessel equivalent and is seeded separately with primary endothelial cells (EC) that are isolated from the lung artery. The second channel acts as reservoir to collect the migrated tumor cells. In contrast to many other systems, this device does not need an additional coating to allow EC growth, as the primary EC that is used produces their own basement membrane. VE-Cadherin, an endothelial adherence junction protein, was expressed in regular localization, which indicates a tight barrier function and cell⁻cell connections of the endothelium. The EC in the device showed in vivo-like behavior under flow conditions. The GFP-transfected tumor cells that were introduced were of epithelial or mesenchymal origin and could be observed by live cell imaging, which indicates tightly adherent tumor cells to the endothelial lining under different flow conditions. These results suggest that the new device can be used for research on molecular requirements, conditions, and mechanism of extravasation and its inhibition.
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Affiliation(s)
- Claudia Kühlbach
- Department of Mechanical und Medical Engineering, Hochschule Furtwangen University, Villingen-Schwenningen 78054, Germany.
- Department of Biochemical Engineering, University College London, London WC1E 6BT, UK.
| | - Sabrina da Luz
- Hahn-Schickard, Villingen-Schwenningen 78054, Germany, .
| | - Frank Baganz
- Department of Biochemical Engineering, University College London, London WC1E 6BT, UK.
| | - Volker C Hass
- Department of Biochemical Engineering, University College London, London WC1E 6BT, UK.
- HFU Hochschule Furtwangen, Department Medical and Life Science, Villingen-Schwenningen 78054, Germany.
| | - Margareta M Mueller
- Department of Mechanical und Medical Engineering, Hochschule Furtwangen University, Villingen-Schwenningen 78054, Germany.
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15
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Koyuncuer A, Cüzdan SS, Şenköy E, Kalacı N. Skin metastasis as the first manifestation of lung carcinoma. Asian Cardiovasc Thorac Ann 2018; 26:320-324. [PMID: 29562758 DOI: 10.1177/0218492318766784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lung cancer is the most frequently diagnosed non-skin cancer and has a high mortality rate. Skin metastases that manifest as visceral malignancies are rare. Cutaneous metastasis from lung cancer has been observed in only 0.22%-12% of cases and is rarely the first manifestation of lung cancer. The histopathological features of metastases are occasionally difficult to distinguish from those of primary cutaneous tumors, despite the rigorous application of useful techniques, particularly immunohistochemistry. We report 3 asymptomatic cases of men who presented with solitary periumbilical, sacral, and scalp metastasis as the first manifestation of an underlying malignant lung tumor.
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Affiliation(s)
- Ali Koyuncuer
- 1 Department of Pathology, 175675 Hatay State Hospital, Hatay , Turkey
| | - Sedat Suat Cüzdan
- 2 Department of Plastic and Reconstructive Surgery, 175675 Hatay State Hospital, Hatay , Turkey
| | - Eyüp Şenköy
- 3 Department of General Surgery, 175675 Hatay State Hospital, Hatay , Turkey
| | - Nesip Kalacı
- 3 Department of General Surgery, 175675 Hatay State Hospital, Hatay , Turkey
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Abstract
A 64-year-old man found a painless soft tissue mass on his nasal tip 3 months ago. The biopsy pathology indicated a metastatic squamous carcinoma. An F-FDG PET/CT scan was performed to detect the primary malignancy, and it demonstrated multiple F-FDG-avid lesions involving the nasal tip, bilateral lungs, right hilum and mediastinum, and rectum. The nasal-tip mass with high radioactivity was diagnosed as the metastasis from squamous lung carcinoma, which was confirmed by the biopsy of a lung lesion.
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17
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Taguchi S, Ogawa T, Takayashiki N, Katayama K, Satoh H. Isolated squamous cell lung cancer metastasis to the scalp. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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18
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Pajaziti L, Hapçiu SR, Dobruna S, Hoxha N, Kurshumliu F, Pajaziti A. Skin metastases from lung cancer: a case report. BMC Res Notes 2015; 8:139. [PMID: 25889083 PMCID: PMC4394421 DOI: 10.1186/s13104-015-1105-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/31/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung cancer is one of the most frequent malignancies, with high mortality rates. It can metastasize in almost all organs, but more often invades hilar nodes, liver, adrenal glands, bones and brain. There are various data on the incidence of lung cancer metastases in the skin. In 1-12% of patients with lung cancer are developed skin metastases. Metastases in the skin may be the first sign of lung cancer. CASE PRESENTATION Forty-five years old Albanian male, smoker, was admitted to our department with multiple nodules localized in the skin of the head, neck, back and chest. The nodules measuring 5-15 millimeters in greatest dimension were round and skin-colored, with telangiectasias, firm and tender. They appeared in an eruptive form about two weeks before being admitted at our hospital. In addition, the patient exhibited signs of weight loss, anorexia and fatigue. Excisional biopsy was performed to one of the lesions. Histopathology confirmed metastatic nature of the lesion namely, malignant tumor of neuroendocrine phenotype consistent with small-cell carcinoma. Chest X-ray and computed tomography revealed an expansive process in the 7(th) segment of the left lung, left hilar and mediastinal lymphadenopathy and a suspicious initial secondary deposit in the left adrenal gland. The patient was referred to the department of oncology for further treatment. After the third cycle of chemotherapy, the magnetic resonance imaging revealed brain metastases. The patient passed away four months after the diagnosis of lung cancer first presented with skin metastases. CONCLUSIONS Metastases in skin may be the first sign of lung cancer. Although rare appearing, we should raise suspicion in cases of atypical lesions in the skin not only of the smokers, but also of the non-smokers. Skin metastases from small-cell lung carcinoma are a poor prognostic indicator. The appearance of multiple skin metastases with other internal metastases shorten the survival time.
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Affiliation(s)
- Laura Pajaziti
- Department of Dermatology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo.
| | - Syzana Rexhepi Hapçiu
- Department of Dermatology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo.
| | - Shkendije Dobruna
- Department of Dermatology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo.
| | - Naim Hoxha
- Department of Radiology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo.
| | - Fisnik Kurshumliu
- Institute of Pathology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo.
| | - Artina Pajaziti
- Faculty of Medicine, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo.
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19
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Babacan NA, Kiliçkap S, Sene S, Kacan T, Yucel B, Eren MF, Cihan S. A Case of Multifocal Skin Metastases from Lung Cancer Presenting with Vasculitic-type Cutaneous Nodule. Indian J Dermatol 2015; 60:213. [PMID: 25814739 PMCID: PMC4372943 DOI: 10.4103/0019-5154.152582] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Although cutaneous metastasis occurs usually at the terminal stage of the disease, it may be rarely concurrent with the diagnosis and may also present as the first sign of the illness. A 55-year-old male patient presented with vasculitic-type cutaneous nodular lesions and a necrotic distal phalangeal lesion developed over the last month. He was a tradesman and smoked 40 packets year. On physical examination, he was found to have multiple cutaneous lesions on the skin of the face, limbs, neck, scalp, dorsal side, fingers, subungual side, right leg, and feet. A skin lesion punch biopsy was performed and squamous cell carcinoma metastasis was detected. He was diagnosed as having squamous cell lung cancer with bronchoscopic biopsy. Although it is very rare, cutaneous metastases that is concurrent with the diagnosis of lung cancer may be the first sign of the disease. In patients with suspicious skin lesions, the patient's age, smoking history, and other symptoms should be evaluated and a biopsy should be performed.
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Affiliation(s)
| | | | - Soner Sene
- Department of Rheumatology, Erciyes University, Kayseri, Turkey
| | - Turgut Kacan
- Department of Medical Oncology, Cumhuriyet University, Sivas, Turkey
| | - Birsen Yucel
- Department of Radiation Oncology, Cumhuriyet University, Sivas, Turkey
| | - Mehmet Fuat Eren
- Department of Radiation Oncology, Cumhuriyet University, Sivas, Turkey
| | - Sener Cihan
- Department of Medical Oncology, Okmeydanı Education and Research Hospital, Kayseri, Turkey
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20
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Lung cancer with skin and breast metastasis: a case report and literature review. Case Rep Pulmonol 2015; 2015:136970. [PMID: 25861506 PMCID: PMC4378697 DOI: 10.1155/2015/136970] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 02/28/2015] [Indexed: 12/05/2022] Open
Abstract
Lung cancer is one of the most common cancers in America. Frequent sites of metastasis include the Hilar lymph nodes, adrenal glands, liver, brain, and bone. The following case report is of a primary lung cancer with metastases to the breast and skin. Case. A 48-year-old African American male with a past medical history of poorly differentiated left breast cancer status after modified radical mastectomy (MRM), chronic obstructive pulmonary disease, and smoking (20 pack-years) presents to the ER with progressive shortness of breath on exertion, upper back pain, and weight loss for 2 months in duration. On physical examination he is found to have a MRM scar on his left breast and a left periumbilical cutaneous mass. Chest X-ray and chest CT reveal a right upper lobe mass and biopsies from the breast, lung, and the periumbilical mass indicate a poorly differentiated carcinoma of unclear etiology; all tumor markers are negative. The patient is male and a chronic smoker; therefore the diagnosis is made as lung carcinoma with metastases to the breast and skin. Conclusion. A high index of suspicion for cutaneous metastases should be cast when investigating cutaneous pathologies in patients at risk for primary lung malignancy.
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21
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Tomar LR, Agarwal MP, Aggarwal A, Narang S, Mishra K. Scalp swelling: An unusual presentation of small cell lung carcinoma. Indian Dermatol Online J 2015; 6:55-7. [PMID: 25657924 PMCID: PMC4314895 DOI: 10.4103/2229-5178.148954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Laxmikant Ramkumarsingh Tomar
- Department of Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Mukul P Agarwal
- Department of Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Amitesh Aggarwal
- Department of Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Salil Narang
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Kiran Mishra
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
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22
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23
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Haghighatkhah HR, Sanei Taheri M, Kharrazi SMH, Ghazanfari Amlashi D, Haddadi M, Pourabdollah M. An unusual case of pulmonary adenocarcinoma with multiple and extraordinary metastases. IRANIAN JOURNAL OF RADIOLOGY 2012; 9:93-8. [PMID: 23329971 PMCID: PMC3522349 DOI: 10.5812/iranjradiol.7733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 05/26/2012] [Accepted: 06/13/2012] [Indexed: 12/28/2022]
Abstract
Pulmonary adenocarcinoma is one of the major types of lung cancers in which metastasis is not uncommon. Hereby, we report a case of pulmonary adenocarcinoma with multiple muscular, cutaneous, pancreatic and peritoneal metastases. Actually, all these features occurring in one patient makes it an extraordinary case. A rare anatomic variation, double inferior vena cava (IVCs), was another rare manifestation in this case.
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Affiliation(s)
- Hamid Reza Haghighatkhah
- Department of Radiology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding author: HamidReza Haghighatkhah, Department of Radiology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel.: +98-2122814331,22814139, Fax: +98-2122814331, E-mail:
| | - Morteza Sanei Taheri
- Department of Radiology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Hadi Kharrazi
- Department of Radiology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mehrnoosh Haddadi
- Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahin Pourabdollah
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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24
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Sim JH, Kim JE, Lee SH, Cho MK, Lee JS, Lee SY. Vulvar skin metastasis of lung squamous cell carcinoma. Ann Dermatol 2011; 23:S179-81. [PMID: 22148044 PMCID: PMC3229059 DOI: 10.5021/ad.2011.23.s2.s179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 01/26/2011] [Accepted: 01/26/2011] [Indexed: 11/29/2022] Open
Abstract
In this study, we examined a case where lung cancer metastasized to the vulvar area. A 79-year-old woman that was a heavy smoker was referred to our department with a short (two-week) history of dyspnea, and with a painful nodule on her right labium majora, which she had noticed almost three years earlier. Histopathologically, the specimen appeared as a poorly differentiated squamous cell carcinoma. The chest X-ray, chest computerized tomography scan, and percutaneous transthoracic needle biopsy via bronchoscopy revealed squamous cell carcinoma in the right upper lobe of the lung. Based on these clinical and histopathological findings, we concluded that her condition was skin metastasis at the right labium majora from the lung cancer, which occurs very rarely.
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Affiliation(s)
- Ji Hoon Sim
- Department of Dermatology, Soonchunhyang University Hospital, Cheonan, Korea
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25
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Carey E, Jones SD, Griffiths P, Baxter P. Metastatic pulmonary adenocarcinoma deposit arising within a cutaneous basal cell carcinoma: a case report. Head Neck Pathol 2011; 5:410-2. [PMID: 21597983 PMCID: PMC3210218 DOI: 10.1007/s12105-011-0263-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Accepted: 04/07/2011] [Indexed: 10/18/2022]
Abstract
Skin metastases are rare complications of internal malignancies, and most commonly arise from primary lung carcinoma (Brownstein and Helwig in Arch Dermatol 105:82-68, 1972). Metastatic cutaneous lesions have not previously been documented to arise within other skin tumours. We report our experience of a solitary pulmonary adenocarcinoma metastasis that arose within a pre-existing basal cell carcinoma in a patient with undiagnosed lung cancer. Immunohistochemistry was invaluable in confirming both the metastatic nature of the secondary skin lesion and its site of origin.
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26
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Pantarotto M, Lombo L, Pereira H, Araújo A. Cutaneous metastasis as the initial manifestation of lung adenocarcinoma. J Bras Pneumol 2011; 37:556-9. [PMID: 21881746 DOI: 10.1590/s1806-37132011000400018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2010] [Accepted: 09/21/2010] [Indexed: 11/21/2022] Open
Abstract
We report the case of a 58-year-old male patient who was referred for oncology consultation due to an epigastric mass that had been growing rapidly for three months. Diagnostic investigation revealed that the mass was a metastasis of stage IV lung adenocarcinoma. The patient received five cycles of chemotherapy with cisplatin and gemcitabine as a first-line treatment, which was interrupted due to major adverse events. Although the pulmonary disease stabilized, the cutaneous disease progressed. The patient then received pemetrexed as a second-line chemotherapy, together with concurrent external radiotherapy, which was well tolerated. There was complete remission of the epigastric mass. However, the patient died three months after the treatment. Here, we emphasize the importance of a multidisciplinary approach and of its role in individualizing the treatment.
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27
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Lee JH, Ahn SJ, Kim HJ, Jang SE, Noh GY, Kim HR, Kim CH, Lee JC. Cutaneous Metastasis from Lung Cancer: A Single-Institution Retrospective Analysis. Tuberc Respir Dis (Seoul) 2011. [DOI: 10.4046/trd.2011.70.2.139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jong Hwan Lee
- Department of Internal Medicine, Korea Cancer Center Hospital, Korean Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Se Jin Ahn
- Department of Internal Medicine, Korea Cancer Center Hospital, Korean Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Hyung Jin Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Korean Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Sang Eon Jang
- Department of Internal Medicine, Korea Cancer Center Hospital, Korean Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Geum Youb Noh
- Department of Internal Medicine, Korea Cancer Center Hospital, Korean Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Hye-Ryoun Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Korean Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Cheol Hyeon Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Korean Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Jae Cheol Lee
- Department of Internal Medicine, Korea Cancer Center Hospital, Korean Institute of Radiological & Medical Sciences, Seoul, Korea
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28
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Dhambri S, Zendah I, Ayadi-Kaddour A, Adouni O, El Mezni F. Cutaneous metastasis of lung carcinoma: a retrospective study of 12 cases. J Eur Acad Dermatol Venereol 2010; 25:722-6. [PMID: 20735519 DOI: 10.1111/j.1468-3083.2010.03818.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The skin is a rare site of metastasis of the internal malignancies. On the contrary, lung cancer is a common primary malignancy of skin metastasis. The latter is either synchronous with the primary lung tumour or can reveal it. OBJECTIVE To analyse the clinical findings and the outcome of cutaneous metastasis in patients with primary lung cancer. METHODS Retrospective study including 12 cases of cutaneous metastasis of lung cancer diagnosed in our institution during 6years. RESULTS Our patients included three women and nine men with a median age of 59.83years. The cutaneous metastases were unique in seven cases. They revealed the primary tumour in two cases, were discovered synchronously with the primary tumour in six cases and after the primary tumour in four cases. They appeared in patients presenting multiple metastases in 10 cases. Clinical appearance consisted on a firm nodule, sometimes ulcerated with a diameter ranging from 0.5 to 5.5cm. The tumour was sited in the thorax, the back, the abdomen; or the upper or lower limbs. Pathological examination of bronchial biopsy revealed an adenocarcinoma in eight cases, a squamous cell carcinoma in two cases and a small cell carcinoma in two cases. In spite of lung cancer therapies, the patients with metastasis to other organs with a median follow-up time of 4months died. CONCLUSION Cutaneous metastases of lung cancer are of poor prognosis. They are most of the time associated with an advanced neoplastic process with metastasis to other organs. Median survival after skin involvement does not exceed months.
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Affiliation(s)
- S Dhambri
- Department of Pathology Department of Pneumology (PAV I), Aderrahmen's Mami Hospital of Respiratory Diseases, Ariana, Tunis, Tunisia
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29
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Camarasa Escrig A, Chiner Vives E, Sancho Chust JN. [Clown nose as an initial manifestation of squamous-cell lung carcinoma]. Arch Bronconeumol 2009; 45:60-1. [PMID: 19186301 DOI: 10.1016/j.arbres.2008.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Accepted: 02/05/2008] [Indexed: 10/21/2022]
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30
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Molina Garrido MJ, Guillén Ponce C, Soto Martínez JL, Martínez Y Sevila C, Carrato Mena A. Cutaneous metastases of lung cancer. Clin Transl Oncol 2006; 8:330-3. [PMID: 16760007 DOI: 10.1007/s12094-006-0178-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It is uncommon for a cancer to be diagnosed because of skin metastases. Cutaneous metastases as initial manifestation of internal neoplasias, represent only 0.8% of total cases and implies, in general, a very advanced grade of the disease and short survival. When skin metastases of an unknown primary site appear, lung cancer is the first option to be discarded in case of men, and breast cancer in case of women. Lung cancer spreads to the skin in 2.8-8.7% of the cases, in advanced phases of the disease, although just in 7-23.8% of the cases, cutaneous metastases appear as first manifestation of the primary tumor. Sometimes, a complete examination to discover the tumor reveals no metastases elsewhere.
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Affiliation(s)
- M J Molina Garrido
- Medical Oncology Service, Hospital General Universitario de Elche, Alicante, Spain.
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31
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Civelek AC, Piotrowski B, Osman MM, Memisoglu E, Khayyat N, Reimers HJ, Naunheim KS. Cutaneous metastatic lung cancer detected with18F-FDG PET. Ann Nucl Med 2006; 20:147-9. [PMID: 16615424 DOI: 10.1007/bf02985627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 48-year-old male smoker presented with a chief complaint of persistent cough for three months. A CT scan revealed only a large right paratracheal mass. The plan was to obtain histological confirmation of suspected lung cancer via bronchoscopy and mediastinoscopy. A whole body 18F-FDG (2-deoxy-2-[18F]fluoro-D-glucose) PET Scan was ordered for staging and localization of the most accessible biopsy site. There was a large, intense hypermetabolic focus corresponding to the paratracheal lesion seen on CT, as well as a lesion in the right adrenal gland. There was also a superficial, subcutaneous hypermetabolic lesion in the mid-back. The subcutaneous lesion, which previously had not been noted, was biopsied and proved to be metastatic adenocarcinoma consistent with the lung primary. This case illustrates the clinical utility of reporting soft tissue abnormalities, which may provide an alternative, more readily accessible location for biopsy that is both safer and less expensive than bronchoscopy or mediastinoscopy.
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Affiliation(s)
- A Cahid Civelek
- Division Nuclear Medicine, Department of Internal Medicine, St. Louis, Missouri 63110, USA.
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32
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Kamiyoshihara M, Sakata K, Otani Y, Kawashima O, Takahashi T, Morishita Y. Solitary skin metastasis after lung cancer resection. THE JAPANESE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY : OFFICIAL PUBLICATION OF THE JAPANESE ASSOCIATION FOR THORACIC SURGERY = NIHON KYOBU GEKA GAKKAI ZASSHI 2002; 50:343-6. [PMID: 12229219 DOI: 10.1007/bf03032629] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 75-year-old woman admitted for an abnormal chest X-ray shadow was found in transbronchial lung biopsy to have malignant cells. After right lower lobectomy with mediastinal lymph node dissection, pathological examination showed primary pulmonary squamous cell carcinoma (pT2N1M0, stage IIB). After discharge, we followed her up as an outpatient, with oral administration of uracil and futrafur (300 mg/day). Five months postoperatively, a subcutaneous mass detected on her back and surgically removed was found histologically to be metastatic squamous cell carcinoma of subcutaneous tissue from lung cancer. No other metastases were found. The patient has survived 3 years and 3 months since primary surgery and remained cancer-free 2 years and 11 months since resection for skin metastasis. Given that skin metastasis is detected when most patients are in an advanced stage of disease, our case was a rare one of solitary skin metastasis after resection for lung cancer.
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Affiliation(s)
- Mitsuhiro Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-Cho, Maebashi, Gunma 371-0014, Japan
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33
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D'Aniello C, Brandi C, Grimaldi L. Cutaneous metastasis from small cell lung carcinoma. Case report. SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 2001; 35:103-5. [PMID: 11291342 DOI: 10.1080/02844310151032736] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We report a rare case of cutaneous metastatic small cell lung carcinoma of the upper lip in a 73-year-old man, which was excised and the defect repaired with a single advancement flap from the cheek. The prognosis of such lesions is poor, and the incidence of other metastases elsewhere is high. The aim of treatment was to give him optimal quality of life for the short time left. The patient died of his primary disease four months later.
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Affiliation(s)
- C D'Aniello
- Unit of Plastic Surgery, University Hospital of Siena, Siena, Italy
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Assmann A, Farthmann B, Burkhardt O, Dippel E, Orfanos CE, Blume-Peytavi U. Cerebriform nodular amelanotic metastases of malignant melanoma: a challenge in differential diagnosis of a rare variant. Br J Dermatol 2000; 142:533-6. [PMID: 10735966 DOI: 10.1046/j.1365-2133.2000.03372.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
High variability of the clinical appearance of malignant melanoma (MM) and its metastases render the differential diagnosis of solid amelanotic tumours difficult. We report a 71-year-old woman with several unusual cutaneous tumours of cerebriform morphology, suggesting skin metastases from occult internal cancer. Histopathological findings and thorough investigations, however, revealed a late-stage metastatic MM. We discuss the differential diagnosis of skin metastases of various origin and underline the difficulties for early detection of MM.
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Affiliation(s)
- A Assmann
- Department of Dermatology, University Medical Centre Benjamin Franklin, The Free University of Berlin, Hindenburgdamm 30, 12200 Berlin, Germany
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35
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Hammert WC, Champagne L, Heckler FR. Metastatic squamous cell carcinoma of the nasal tip: a case report. J Oral Maxillofac Surg 1999; 57:186-9. [PMID: 9973129 DOI: 10.1016/s0278-2391(99)90237-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- W C Hammert
- Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Allegheny University of the Health Sciences, Pittsburgh, PA 15212-9986, USA.
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36
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Caubet-Biayna J, Morey-Mas M, Ibarra J, Iriarte-Ortabe JI. Scalp metastases as the first manifestation of a lung adenocarcinoma. J Oral Maxillofac Surg 1998; 56:247-50. [PMID: 9461155 DOI: 10.1016/s0278-2391(98)90879-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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37
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Toubes Navarro M, Tábara Rodríguez J, Domínguez Juncal L. Metástasis cutánea tardía del carcinoma de pulmón en región inguinal. Arch Bronconeumol 1997. [DOI: 10.1016/s0300-2896(15)30524-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Abstract
We present a long-term survivor with isolated recurrent tumor in the incisional scar that developed 9 months after a curative resection for primary lung adenocarcinoma. She underwent an excision of the tumor followed by systemic chemotherapy, and is currently alive with no evidence of disease 69 months after the recurrence. Isolated incisional recurrence after complete resection of lung cancer is a rare phenomenon and may be curable using multimodal treatment.
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Affiliation(s)
- K Yokoi
- Division of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya, Japan
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39
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Kamble R, Kumar L, Kochupillai V, Sharma A, Sandhoo MS, Mohanti BK. Cutaneous metastases of lung cancer. Postgrad Med J 1995; 71:741-3. [PMID: 8552539 PMCID: PMC2398294 DOI: 10.1136/pgmj.71.842.741] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The reported incidence of skin metastases from lung cancer varies from 2.8-7.5%. In the present study 8.7% of patients had skin metastases, with head and neck being the most common sites, nodular lesions the most common, and adenocarcinoma the most frequent histology. Although most patients develop these lesions during the course of a known progressive disease, they may be the presenting manifestation of a primary tumour in the lung. The occurrence of skin lesions in lung cancer announces an ominous prognosis. The response to chemotherapy is poor, possibly due to poor blood supply to the skin; monitoring response to chemotherapy, however, is easier when such lesions are present.
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Affiliation(s)
- R Kamble
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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40
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Abstract
We describe findings in 34 cases of lung cancer with skin metastases. In 24 men and 10 women, ages ranged from 32 to 85 years (mean, 61 years). In five, a skin lesion was the first manifestation of the underlying cancer; in another four, it was found coincidentally with detection of the lung mass. Pathologic findings included adenocarcinoma in 18 patients, large-cell carcinoma in 9, squamous cell carcinoma in 5, and small-cell carcinoma in 2. Among 87 patients with large-cell carcinoma, 9 (10.3 percent) developed cutaneous metastases. A review of 510 autopsies of primary lung cancer at Keio University from 1958 to 1992 showed 25 cases with skin metastases (4.9 percent), adenocarcinoma in 13 cases, large-cell carcinoma in 6, squamous cell carcinoma in 4, and small-cell carcinoma in 2. Skin metastases were proven in 15.4 percent of autopsy cases of large-cell carcinoma of the lung. Mean survival time from diagnosis of lung cancer was 10.3 months and that from diagnosis of skin metastasis was 4.9 months. The prognosis for patients having lung cancer with skin metastasis is thus very poor. In the review of 34 patients and 25 autopsies of lung cancer with skin metastasis, we conclude that the incidence of cutaneous metastasis is high for large-cell carcinoma and low for squamous and small-cell carcinoma.
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Affiliation(s)
- T Terashima
- Department of Medicine, School of Medicine, Keio University, Tokyo, Japan
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Abstract
A case is reported of oat cell carcinoma of the lung presenting with unusual sites of metastasis to the orofacial region. Distant metastases are common in oat cell carcinoma but a literature review did not reveal any reports of metastases either to the hard palate or to medial canthus of the eye.
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Affiliation(s)
- R Capper
- Department of Otolaryngology, Ulster Hospital, Belfast
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Hofer CA, Tenholder MF. Hard nontender masses over the left mandible and scapula. Chest 1991; 100:1444-6. [PMID: 1935308 DOI: 10.1378/chest.100.5.1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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