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Sakhri S, Zemni I, Ayadi MA, Naija L, Boujelbene N, Ben Dhiab T. Cutaneous metastasis as a first presentation of lung carcinoma: a case series. J Med Case Rep 2023; 17:315. [PMID: 37481539 PMCID: PMC10363314 DOI: 10.1186/s13256-023-04029-2] [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: 03/29/2023] [Accepted: 06/06/2023] [Indexed: 07/24/2023] Open
Abstract
INTRODUCTION Cutaneous metastases (CM) revealing lung carcinoma are extremely rare, accounting for 0.8%. The diagnosis is guided by histology and immunohistochemistry. Treatment is palliative. The prognosis is poor. CASE PRESENTATION This is a retrospective study of the available clinical and histological records of four North African patients with CM revealing lung cancer treated at our institute between 2004 and 2010. Three men and one woman were registered. The mean age was 54.5 years (38-74 years). Two patients had primary adenocarcinoma, one patient had small cell carcinoma and one had squamous cell carcinoma. Treatment was based on chemotherapy in two cases and antalgic radiotherapy in two cases, one patient underwent surgical resection as the lesion was infected. The overall survival after diagnosis was between one and four months. CONCLUSIONS A skin nodule can be the first symptom revealing lung cancer. A rare clinical presentation that should not be taken for a benign nodule, the biopsy and histological study with immunohistochemistry confirm the diagnosis.
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Affiliation(s)
- Saida Sakhri
- Department of Surgical Oncology,, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ines Zemni
- Department of Surgical Oncology,, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
- LMBA (LR03ES03), Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Mohamed Ali Ayadi
- Department of Surgical Oncology,, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- LMBA (LR03ES03), Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Lamia Naija
- Department of Surgical Oncology,, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nadia Boujelbene
- LMBA (LR03ES03), Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Pathology, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Tarek Ben Dhiab
- Department of Surgical Oncology,, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Paolino G, Pampena R, Grassi S, Mercuri SR, Cardone M, Corsetti P, Moliterni E, Muscianese M, Rossi A, Frascione P, Longo C. Alopecia neoplastica as a sign of visceral malignancies: a systematic review. J Eur Acad Dermatol Venereol 2019; 33:1020-1028. [PMID: 30767283 DOI: 10.1111/jdv.15498] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 01/18/2019] [Indexed: 12/11/2022]
Abstract
Alopecia neoplastica (AN) from visceral tumours is a rare form of cutaneous metastasis in which internal malignancies spread to the scalp. The diagnosis of AN may be very challenging, especially when its onset precedes the diagnosis of the primary tumour. We aimed to improve the knowledge on AN, highlighting that in case of scarring localized alopecia, a differential diagnosis with metastasis should always be considered. We performed a systematic review to describe the main demographic and clinical features associated with AN from visceral malignancies; a survival analysis was also performed. In 118 reports, accounting for 123 patients, we found that women were more affected by AN than men (53.7% vs. 46.3%). The most frequent site of the primary tumour was the gastrointestinal tract (24.4%), followed by breast (17.9%), kidney (8.1%), lung (7.3%), thyroid (7.3%), uterus (6.5%), central nervous system (6.5%), liver (3.3%) and other anatomic areas for 18.7% of cases. Furthermore, in more than half of the cases (66.1%), AN lesions were single and were mainly diagnosed after the primary visceral tumour (71.5%). Finally, survival analysis highlighted a lower progression-free survival in men; while, no significant differences in overall survival were reported among genders. In conclusion, metastatic skin disease should always be taken into consideration when dealing with patients with localized scarring alopecia.
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Affiliation(s)
- G Paolino
- Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy.,Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | - R Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Grassi
- Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | - S R Mercuri
- Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy
| | - M Cardone
- Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | - P Corsetti
- Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | - E Moliterni
- Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | - M Muscianese
- Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | - A Rossi
- Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | - P Frascione
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - C Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Dermatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
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