[Zosteriform cutaneous metastasis in melanoma]

Lymphangitic Melanomatosis: Case Report of Intralymphatic Spread of Melanoma in a 66-year-old Man

ABSTRACT

Melanoma with lymphatic invasion has been associated with increased risk of metastasis, but the mechanisms and clinical implications are poorly understood. Although current reports have documented angiotropic spread of melanoma and suggest lymphatic spread of melanoma to increase the likelihood of metastasis, to our knowledge, lymphangitic metastatic melanoma resembling cutaneous carcinomatosis or presenting with facial hyperpigmentation has not been described. In this case report, we describe extensive cutaneous intralymphatic spread of melanoma, or lymphangitic melanomatosis, producing macular skin pigmentation in a 66-year-old man.

Metastatic melanoma and rare melanoma variants: a review

The histopathological diagnosis of melanoma is fraught with potential pitfalls. In the setting of cutaneous metastatic melanoma, it is important to recognise the various histological patterns that can be encountered from the more common to the rare, including epidermotropic, folliculotropic, naevoid, and blue naevus-like. In addition, melanoma is notorious for phenotypic plasticity. Thus, there are many different subtypes and cytomorphological variations that can be difficult to recognise as melanoma, particularly in the recurrent or metastatic setting. Select melanoma variants including primary dermal, clear cell, plasmacytoid, signet ring cell, small cell, myxoid, rhabdoid, and dedifferentiated melanoma will be discussed, in addition to composite melanocytic neoplasms. This review is intended to remind the practitioner of key concepts of metastatic disease and select rare melanoma variants, while providing practical guidelines for accurate diagnosis.

Zosteriform Cutaneous Metastases with Primary Endometrial Carcinoma

Cutaneous metastases from endometrial adenocarcinoma are ominous and are seldom seen, though metastases occurring at the local sites, such as pelvic and para-aortic lymph nodes, vagina, peritoneum, and lungs are well recognized. The zosteriform pattern of lesions is even more rare. Here, we describe an interesting case of a 60-year-old female with carcinoma endometrium, presenting with zosteriform cutaneous metastasis.

Ulcerated zosteriform nodules in adenocarcinoma of the colon

Histiocytoid Sweet's syndrome (HSS) is a rare variant of Sweet's syndrome that typically has similar clinical findings to the classic variant but is diagnosed after histologic review. It is characterized by a dermal infiltrate composed of immature, nonblastic myeloid cells with a histiocytic appearance. In this report, we present a case of a 56-year-old Hispanic man with history of stage IIIB adenocarcinoma of the colon who presented with a case of HSS that mimicked a zosteriform cutaneous metastasis. Several types of cancers can metastasize to the skin, leading to varying cutaneous presentations. In particular, a zosteriform dermatomal distribution of cutaneous metastasis is common in melanoma and has been reported in other cancers, such as colon and breast. To our knowledge, this is the first case in which the clinical presentation of HSS appeared in a zosteriform pattern and distribution.