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O'Neill G, Straight C, Helm K. A painful rash on a white woman. JAAD Case Rep 2020; 6:1095-1097. [PMID: 33005713 PMCID: PMC7511648 DOI: 10.1016/j.jdcr.2020.08.009] [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: 11/27/2022] Open
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2
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Yeniocak A, Çamlı MF, Geçer M, Yildiz K. Nodule on scalp: As a metastatic gastric cancer. Dermatol Ther 2020; 33:e13886. [PMID: 32578321 DOI: 10.1111/dth.13886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/14/2020] [Accepted: 06/18/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Ali Yeniocak
- Department of Plastic, Reconstructive and Aesthetic Surgery, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Fatih Çamlı
- Department of Plastic, Reconstructive and Aesthetic Surgery, Bezmialem Vakif University, Istanbul, Turkey
| | - Melin Geçer
- Department of Pathology, Bezmialem Vakif University, Istanbul, Turkey
| | - Kemalettin Yildiz
- Department of Plastic, Reconstructive and Aesthetic Surgery, Bezmialem Vakif University, Istanbul, Turkey
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3
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Menghani SV, Barbosa A, Sagerman P, Beal MW, Scott A. Gastric Cardia Adenocarcinoma with Metastasis to the Scalp: A Case Report. Cureus 2020; 12:e6781. [PMID: 32140341 PMCID: PMC7045980 DOI: 10.7759/cureus.6781] [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] [Indexed: 11/16/2022] Open
Abstract
Cutaneous metastasis is a rare manifestation of advanced gastrointestinal (GI) cancers. Gastric adenocarcinoma rarely presents with cutaneous metastasis, as cutaneous manifestations occur in less than 1% of upper GI tract malignancies. Here, we present the case of a patient with advanced gastric cardia adenocarcinoma with metastasis to the right occipital region of the scalp. Following shave biopsy, the immunohistochemistry (IHC) and molecular profile of the scalp lesion were analyzed, both of which confirmed metastasis and guided the treatment approach. The lesion demonstrated programmed death ligand-1 (PD-L1), an immune checkpoint protein, positivity by IHC, which led to the recommendation for treatment with immunotherapy as per the National Comprehensive Cancer Network (NCCN) guidelines. Clinicians should conduct dermatologic examinations in patients with a history of gastric cancer or who are currently undergoing chemotherapy for gastric cancer in order to monitor for disease progression or metastatic lesions. The aim of this report is to increase awareness of scalp metastasis as an indicator of advanced internal visceral carcinoma for earlier diagnosis and improved management of the condition.
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Affiliation(s)
- Sanjay V Menghani
- Internal Medicine, University of Arizona College of Medicine, Tucson, USA
| | - Alexandra Barbosa
- Internal Medicine, University of Arizona College of Medicine, Tucson, USA
| | - Paul Sagerman
- Pathology, Pathology Biomedical Consulting, Tucson, USA
| | - Matthew W Beal
- Dermatology, University of Arizona College of Medicine, Tucson, USA
| | - Aaron Scott
- Oncology, University of Arizona Cancer Center, Tucson, USA
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4
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Knowles KJ, Chen S, Herrera GA. Metastatic Colonic Adenocarcinoma to the Extrahepatic Common Bile Duct: The Critical Role of the Pathologist and Immunohistochemistry in Guiding Patient Care Decisions. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:263-266. [PMID: 28289273 PMCID: PMC5362023 DOI: 10.12659/ajcr.901501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Patient: Male, 49 Final Diagnosis: Acute hepatitis Symptoms: Malaise • fatigue and dyspnea Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- Kurt J Knowles
- Department of Pathology, Louisiana Health Science Center, Shreveport, LA, USA
| | - Shoujun Chen
- Department of Pathology, Louisiana Health Science Center, Shreveport, LA, USA
| | - Gillermo A Herrera
- Department of Pathology, Louisiana Health Science Center, Shreveport, LA, USA
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5
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Jung JY, Goo EJ, Lee JC, Song J, Koh SA, Lee KH, Bae YK. Metastatic eyelid cancer from gastric adenocarcinoma. Yeungnam Univ J Med 2016. [DOI: 10.12701/yujm.2016.33.2.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ji Yoon Jung
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Eun Joo Goo
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jae Chang Lee
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jay Song
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sung Ae Koh
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Kyung Hee Lee
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Young Kyung Bae
- Department of Pathology, College of Medicine, Yeungnam University, Daegu, Korea
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6
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Gao D, Li S. Stimuli-induced organ-specific injury enhancement of organotropic metastasis in a spatiotemporal regulation. Pathol Oncol Res 2013; 20:27-42. [PMID: 24357158 DOI: 10.1007/s12253-013-9734-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 12/05/2013] [Indexed: 12/11/2022]
Abstract
The relationship between inflammation and tumorigenesis has been established. Recently, inflammation is also reported to be a drive force for cancer metastasis. Further evidences show that various stimuli directly induced-injury in a specific organ can also promote metastasis in this organ, which include epidemiological reports, clinical series and experimental studies. Each type of cancer has preferential sites for metastasis, which is also due to inflammatory factors that are released by primary cancer to act on these sites and indirectly induce injuries on them. Host factors such as stress,fever can also influence distant metastasis in a specific site through stimulation of immune and inflammatory effects. The five aspects support an idea that specific-organ injury directly induced by various stimuli or indirectly induced by primary tumor or host factors activation of proinflammatory modulators can promote metastasis in this organ through a spatiotemporal regulation, which has important implications for personalized prediction, prevention and management of cancer metastasis.
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Affiliation(s)
- Dongwei Gao
- , 536 Hospital of PLA, 29# Xiadu street, Xining, 810007, Qinghai Province, People's Republic of China,
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7
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Cutaneous metastases from internal malignancies: a clinicopathologic and immunohistochemical review. Am J Dermatopathol 2012; 34:347-93. [PMID: 22617133 DOI: 10.1097/dad.0b013e31823069cf] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Skin metastases occur in 0.6%-10.4% of all patients with cancer and represent 2% of all skin tumors. Skin metastases from visceral malignancies are important for dermatologists and dermatopathologists because of their variable clinical appearance and presentation, frequent delay and failure in their diagnosis, relative proportion of different internal malignancies metastasizing to the skin, and impact on morbidity, prognosis, and treatment. Another factor to take into account is that cutaneous metastasis may be the first sign of clinically silent visceral cancer. The relative frequencies of metastatic skin disease tend to correlate with the frequency of the different types of primary cancer in each sex. Thus, women with skin metastases have the following distribution in decreasing order of frequency of primary malignancies: breast, ovary, oral cavity, lung, and large intestine. In men, the distribution is as follows: lung, large intestine, oral cavity, kidney, breast, esophagus, pancreas, stomach, and liver. A wide morphologic spectrum of clinical appearances has been described in cutaneous metastases. This variable clinical morphology included nodules, papules, plaques, tumors, and ulcers. From a histopathologic point of view, there are 4 main morphologic patterns of cutaneous metastases involving the dermis, namely, nodular, infiltrative, diffuse, and intravascular. Generally, cutaneous metastases herald a poor prognosis. The average survival time of patients with skin metastases is a few months. In this article, we review the clinicopathologic and immunohistochemical characteristics of cutaneous metastases from internal malignancies, classify the most common cutaneous metastases, and identify studies that may assist in diagnosing the origin of a cutaneous metastasis.
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8
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Alcaraz I, Santonja C, Kutzner H, Requena L. Signet-ring cell gastric adenocarcinoma metastasizing into a primary cutaneous squamous cell carcinoma of the scalp. J Cutan Pathol 2012. [DOI: 10.1111/j.1600-0560.2012.01928_2.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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9
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Lobular Breast Carcinoma Metastasis to a Superficial Plexiform Schwannoma as the First Evidence of an Occult Breast Cancer. Am J Dermatopathol 2011; 33:845-9. [DOI: 10.1097/dad.0b013e31820d9c0e] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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10
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Schwartz RA, Rothenberg J. Metastatic adenocarcinoma of breast within a benign melanocytic nevus in the context of cutaneous breast metastatic disease. J Cutan Pathol 2009; 37:1251-4. [DOI: 10.1111/j.1600-0560.2009.01480.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Iijima M, Nakayama J, Nishizawa T, Ishida A, Ishii K, Ota H, Katsuyama T, Saida T. Usefulness of Monoclonal Antibody HIK1083 Specific for Gastric O-glycan in Differentiating Cutaneous Metastasis of Gastric Cancer From Primary Sweat Gland Carcinoma. Am J Dermatopathol 2007; 29:452-6. [PMID: 17890913 DOI: 10.1097/dad.0b013e31814691e7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Distinguishing cutaneous metastasis of gastric cancer from primary sweat gland carcinoma can be problematic in some cases, especially with a single lesion. Previously we showed that a monoclonal antibody HIK1083 directed to alpha1,4-GlcNAc-capped O-glycans expressed in gastric gland mucin reacts to gastric cancer cells. By contrast, it was reported that immunohistochemistry for cytokeratin 20 (CK20) may be helpful in the differential diagnosis between cutaneous metastasis of gastric cancer and primary sweat gland carcinoma. Here, we immunohistochemically examined the expression of alpha1,4-GlcNAc-capped O-glycans and CK20 in 7 primary sweat gland carcinomas, 7 cutaneous metastases of gastric cancer, and 21 cutaneous metastases of other origin including breast, lung, colorectum, prostate, thyroid and pancreas using HIK1083 and CK20-specific Ks 20.8 antibodies and then assessed the usefulness of these antibodies in distinguishing cutaneous metastases of gastric cancer from primary sweat gland carcinoma and other cutaneous metastatic tumors. Both alpha1,4-GlcNAc-capped O-glycans and CK20 were positive in 5 of 7 cases of cutaneous metastases of gastric cancer, while neither alpha1,4-GlcNAc-capped O-glycans nor CK20 were detected in any of the primary sweat gland carcinomas. By contrast, alpha1,4-GlcNAc-capped O-glycans was not detected in any of the cutaneous metastases other than that of gastric cancer, whereas CK20 was detected in cutaneous metastases of colorectal cancer (2/2), breast cancer (2/13), and lung adenocarcinoma (1/3). These findings indicate that immunohistochemistry using HIK1083 antibody is superior to immunohistochemistry for CK20 in distinguishing cutaneous metastasis of gastric cancer from primary sweat gland carcinomas and other cutaneous metastases.
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Affiliation(s)
- Miwako Iijima
- Department of Dermatology, School of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
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12
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Resnik KS, DiLeonardo M, Gibbons G. Clinically occult cutaneous metastases. J Am Acad Dermatol 2006; 55:1044-7. [PMID: 17110220 DOI: 10.1016/j.jaad.2006.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2006] [Revised: 03/29/2006] [Accepted: 05/05/2006] [Indexed: 11/29/2022]
Abstract
Cutaneous metastases present themselves in a variety of clinical patterns and tend to be manifested as indurated papules/nodules/tumors. Some of those clinical expressions are unique for certain types of metastases. This report describes an entirely different phenomenon of clinically incognito cutaneous metastases that were only apparent histopathologically as an incidental finding.
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MESH Headings
- Aged
- Aged, 80 and over
- Anastrozole
- Antimetabolites, Antineoplastic/therapeutic use
- Antineoplastic Agents, Hormonal/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biopsy/adverse effects
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Capecitabine
- Carcinoma/diagnosis
- Carcinoma/drug therapy
- Carcinoma/pathology
- Carcinoma/secondary
- Carcinoma, Basal Cell/pathology
- Carcinoma, Basal Cell/surgery
- Carcinoma, Lobular/diagnosis
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Carcinoma, Signet Ring Cell/diagnosis
- Carcinoma, Signet Ring Cell/drug therapy
- Carcinoma, Signet Ring Cell/pathology
- Carcinoma, Signet Ring Cell/secondary
- Deoxycytidine/analogs & derivatives
- Deoxycytidine/therapeutic use
- Estradiol/administration & dosage
- Estradiol/analogs & derivatives
- Facial Neoplasms/drug therapy
- Facial Neoplasms/pathology
- Facial Neoplasms/secondary
- Facial Neoplasms/surgery
- Female
- Fluorouracil/analogs & derivatives
- Fulvestrant
- Humans
- Incidental Findings
- Letrozole
- Mastectomy, Radical
- Megestrol Acetate/administration & dosage
- Melanoma/pathology
- Melanoma/surgery
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/surgery
- Neoplastic Cells, Circulating
- Nitriles/administration & dosage
- Nitriles/therapeutic use
- Selective Estrogen Receptor Modulators/therapeutic use
- Skin Neoplasms/diagnosis
- Skin Neoplasms/drug therapy
- Skin Neoplasms/pathology
- Skin Neoplasms/secondary
- Skin Neoplasms/surgery
- Tamoxifen/administration & dosage
- Tamoxifen/therapeutic use
- Triazoles/administration & dosage
- Triazoles/therapeutic use
- Wound Healing
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Affiliation(s)
- Kenneth S Resnik
- Institute for Dermatopathology, Conshohocken, Pennsylvania 19428, USA.
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13
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Sahin S, Hindioğlu U, Benekli M, Sivri B, Sökmensüer C, Sungur A. Peculiar inflammatory cutaneous metastasis from stomach adenocarcinoma. Br J Dermatol 1997; 136:650-2. [PMID: 9155992 DOI: 10.1111/j.1365-2133.1997.tb02179.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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14
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Abstract
In cutaneous metastatic disease the histologic pattern may be specific or nonspecific. Carcinoma cutis most often shows only the nonspecific pattern of an adenocarcinoma, a squamous cell carcinoma, or an undifferentiated metastatic tumor. However, certain clinical and histologic characteristics may suggest a primary tumor site and type. In addition, special histologic stains and the use of immunohistochemical and electronmicroscopic techniques may also prove valuable in the diagnosis of carcinoma cutis and other cutaneous metastatic diseases.
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Affiliation(s)
- R A Schwartz
- New Jersey Medical School, Newark 07103-2714, USA
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15
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Abstract
The relative frequencies of cutaneous metastases are similar to those of the primary cancers; breast, colon, and melanoma are the most frequent in women and lung, colon, and melanoma are the most common in men. Cutaneous metastases represent an opportunity to detect a potentially treatable cancer before other evidence of it is present, to modify therapy as appropriate to the tumor stage, or possibly to use the cutaneous lesion as a source of easily accessible tumor cells for specific therapy. Cutaneous metastatic disease as the first sign of internal cancer is most commonly seen with cancer of the lung, kidney, and ovary.
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Affiliation(s)
- R A Schwartz
- New Jersey Medical School, Newark 07103-2714, USA
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