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Taghavi M, Ahmadi R, Qutbi M. Cutaneous Metastasis From Prostate Cancer on Posttherapeutic 177 Lu-Prostate-Specific Membrane Antigen Scan. Clin Nucl Med 2024; 49:e217-e218. [PMID: 38409757 DOI: 10.1097/rlu.0000000000005130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
ABSTRACT In this note, we aim to present a patient with a known case of prostate cancer with widespread metastasis to the skeleton and liver who has undergone several cycles of chemoradiotherapy. The patient received 2 doses of 177 Lu-prostate-specific membrane antigen therapy, in which several zones of uptake were detected on the thoracic wall compatible with cutaneous metastatic lesions of prostate cancer.
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Affiliation(s)
| | - Reyhane Ahmadi
- Department of Nuclear Medicine and Molecular Imaging, Farshchian Heart Center, School of Medicine, Hamadan University of Medical Sciences, Hamadan
| | - Mohsen Qutbi
- Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid, Beheshti University of Medical Sciences, Tehran, Iran
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Yamai D, Shimada Y, Ozeki H, Matsumoto A, Abe K, Tajima Y, Nakano M, Ichikawa H, Sakata J, Wakai T. Axillary cutaneous metastasis of colon cancer with microsatellite instability-high and BRAF V600E mutation treated with curative-intent surgery: a case report. Surg Case Rep 2023; 9:196. [PMID: 37962682 PMCID: PMC10646071 DOI: 10.1186/s40792-023-01780-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) metastasizes to various organs, while cutaneous metastases are rare. Although there have been several previous reports of axillary cutaneous metastases with other metastases of CRC, there has never been a report of axillary cutaneous metastasis of CRC that could be treated with curative-intent surgery. CASE PRESENTATION A 68-year-old female was diagnosed with an axillary cutaneous tumor and ascending colon cancer with invasion to the duodenum. Histopathological and immunohistochemical analysis revealed that the axillary cutaneous tumor showed adenocarcinoma and the same expression pattern for cytokeratin 7, cytokeratin 20, and CDX2 as the ascending colon cancer, and that proved to be KRAS-NRAS wild type, MSI-H, and with a BRAF V600E mutation. The patient underwent a two-stage resection with curative intent after receiving neoadjuvant chemotherapy which consisted of one cycle of modified FOLFOX6 followed by two cycles of FOLFOXIRI. During and after the two operations, the patient received a total of nine cycles of modified FOLFOX6 as adjuvant chemotherapy. Two years after the initial surgery, and 1 year and 8 months after the second surgery, the patient is alive without recurrence. CONCLUSIONS To the best of our knowledge, this is the first report of axillary cutaneous metastasis of CRC with microsatellite instability-high and BRAF V600E mutation that could be treated with curative-intent surgery. It is important to recognize the presence of such cases for the accurate diagnosis and treatment of CRC with cutaneous metastasis.
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Affiliation(s)
- Daisuke Yamai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
- Medical Genome Center, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan.
| | - Hikaru Ozeki
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Akio Matsumoto
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Kaoru Abe
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Yosuke Tajima
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Mae Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
- Medical Genome Center, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
- Medical Genome Center, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan
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Li H, Parke M, Montanez-Wiscovich M. Cutaneous Ovarian Carcinoma Metastases: Case Report and Literature Review. Cureus 2023; 15:e44459. [PMID: 37791206 PMCID: PMC10544161 DOI: 10.7759/cureus.44459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Metastatic cutaneous ovarian carcinoma is a rare diagnosis with a poor prognosis. Cutaneous manifestations are variable in size and morphology. We report a woman presenting with cutaneous ovarian metastases mimicking reticulated dermatoses. Our patient presented with a four-month history of a mildly pruritic eruption in the setting of stage IV ovarian adenocarcinoma, for which she was undergoing carboplatin, doxorubicin, and bevacizumab chemotherapy. On exam, she had erythematous, indurated papules and plaques involving the right flank and breast, as well as a reticulated erythematous patch on the lower abdomen. Cutaneous ovarian metastases have varied presentations. Our case highlights an uncommon manifestation of ovarian metastases and reviews the prior literature.
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Affiliation(s)
- Han Li
- Dermatology, University of Florida College of Medicine, Gainesville, USA
| | - Milbrey Parke
- Dermatology, University of Florida College of Medicine, Gainesville, USA
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Bulut E, Taştekin E, Topuz C, Öztürk S, Gökyer A. Exceptional Variant with Distant Cutaneous Metastasis as the First Clinical Sign in Gastric Signet-Ring Carcinoma. J Gastrointest Cancer 2021; 53:1135-1137. [PMID: 34786642 DOI: 10.1007/s12029-021-00747-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Skin metastases from gastric cancer are rare and usually occur very late in the course of the disease. The most common metastatic sites liver, the peritoneal surfaces, and the non regional or distant lymph nodes. CASE REPORT In this case we report the short-term survival of a 67-year-old man complined of multiple nodular lesions in various part of his skin. Histology showed a metastatic signet ring cell adenocarsinoma. Esophagogastroduodenoscopy was performed and a crater- like ulcer, about 3 cm in diameter, was observed on the anterior part of the stomach corpus distal. A biopsy specimen was obtained, and histopathological findings were consistent with gastric signet-ring cell carcinoma. XELOX chemotherapy regimen was initiated for the patient. CONCLUSION Skin metastasis of gastric adenocarcinoma is a rare condition with a poor prognosis. It may be the first manifestation of a clinically silent visceral cancer or may represent a recurrence of an internal malignancy.
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Affiliation(s)
- Ezgi Bulut
- Trakya University School of Medicine, Edirne, Turkey
| | - Ebru Taştekin
- Department of Pathology, Trakya University School of Medicine, Edirne, Turkey
| | - Canberk Topuz
- Department of Pathology, Trakya University School of Medicine, Edirne, Turkey
| | - Sevgi Öztürk
- Department of Dermatology, Çanakkale 18 Mart School of Medicine, Çanakkale, Turkey
| | - Ali Gökyer
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey.
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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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Park HK, Choi YD, Yun SJ. Clinical characteristics and differences among 802 acral tumors by anatomical sites. Clin Exp Dermatol 2021; 47:312-318. [PMID: 34388274 DOI: 10.1111/ced.14885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acral skin tumors are common, but there are few literature reviews regarding their incidence. OBJECTIVES To investigate the clinical characteristics and differences in incidence of benign and malignant acral tumors by anatomical site. METHODS A retrospective review of 802 patients with acral skin tumors confirmed by skin biopsy between January 2010 and December 2019 was conducted. Age, sex, duration, symptoms, and sites were obtained from medical records and photographs. RESULTS The mean age of onset was 43.8 years with a male-to-female ratio of 1:1.41, and the mean duration was 68.8 months. Most were asymptomatic (66.7%). In total, 802 acral tumors were identified: 512 (63.8%) were benign and 290 (36.2%) were malignant. The most common benign tumors were benign melanocytic lesions (n = 239), and the most common malignant tumors were melanoma (n = 234). The most common site was the sole (n = 408). Benign melanocytic lesions, melanoma, and epidermal cyst were more frequent on the foot, and pyogenic granuloma, glomus tumor, hemangioma, and mucous cyst were more frequent on the hand. Glomus tumor, fibroma, mucous cyst, and osteoma were more frequent on the nail portion, and benign melanocytic lesions and epidermal cyst were more frequent on the non-nail portion. CONCLUSIONS This study reports the incidence of various benign and malignant acral tumors according to site, and we believe the results will be helpful in making a diagnosis in the clinic.
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Affiliation(s)
- H K Park
- Departments of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Y D Choi
- Departments of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - S J Yun
- Departments of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Correia P, Correia JF, Scigliano H, Nora M. Unusual Cutaneous Metastases From Colon Adenocarcinoma. Cureus 2021; 13:e14065. [PMID: 33898148 PMCID: PMC8062121 DOI: 10.7759/cureus.14065] [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: 11/23/2022] Open
Abstract
Skin metastases from internal malignancies are rare, even more from colorectal tumours, and are usually a sign of disseminated disease with a poor prognosis. However, with increased numbers of cancer survivors, a high index of suspicion should exist during the evaluation of cutaneous lesions since it can be the initial sign of disease progression or even the first sign that triggers a malignancy diagnosis, potentially improving the patient's odds. Herein, we report a case of synchronous cutaneous metastases from colon adenocarcinoma with unusual localization on the back and forearm of a 65-year-old man.
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Affiliation(s)
- Penélope Correia
- General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Joana F Correia
- General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Horácio Scigliano
- Pathology, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Mário Nora
- General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
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Iñiguez-Ariza NM, Lee RA, Brewer JD, Hay ID. Elimination of Locoregional Recurrences and Skin Metastases in Papillary Thyroid Cancer by Ethanol Ablation and Mohs Surgery. J Endocr Soc 2020; 4:bvaa095. [PMID: 32803095 PMCID: PMC7417876 DOI: 10.1210/jendso/bvaa095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/04/2020] [Indexed: 12/19/2022] Open
Abstract
Ultrasound-guided percutaneous ethanol ablation procedures for locoregional recurrences in papillary thyroid carcinoma (PTC) can be repeatedly performed over years. Skin metastases (SM) from PTC generally portend a lethal prognosis. Our patient case report demonstrates the innovative use in low-risk PTC (LRPTC) of treatment modalities designed to prevent neck re-explorations and capable of eliminating both locoregional recurrences and SM. In 2004, a 48-year-old man presented with neck nodal metastases due to PTC. He underwent a near-total thyroidectomy and nodal dissection, confirming an 8-mm PTC involving 2 ipsilateral node metastases. Postoperatively, he received 2 doses of radioactive iodine (RAI) for remnant uptake (cumulative dose 338 mCi); posttherapy scanning was unrevealing. In 2007, he underwent right neck dissection for further node metastases. In 2008, a guided biopsy confirmed a level IV node metastasis. He was referred to our institution for ethanol ablation. Two node metastases were ablated and subsequently disappeared. During 2010-2016, he developed an additional 6 node metastases, which were treated with ethanol ablation; all disappeared on high-resolution sonography. FDG-PET-CT scans in 2009 and 2016 were negative for distant spread. In 2016, a SM in his right neck was removed by dermatologic surgery. In 2017-2018, 2 further SM were excised with negative margins, one after Mohs surgery. He has now been disease-free for 20 months. In conclusion, despite 3 neck surgeries and 2 RAI therapies, our patient repeatedly developed both locoregional recurrences and SM. All 11 disease foci were eliminated with minimally invasive procedures which should more often be considered as effective treatment options in LRPTC.
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Affiliation(s)
- Nicole M Iñiguez-Ariza
- Division of Endocrinology, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, Minnesota
| | - Robert A Lee
- Department of Radiology, Mayo Clinic and College of Medicine, Rochester, Minnesota
| | - Jerry D Brewer
- Department of Dermatology, Mayo Clinic and College of Medicine, Rochester, Minnesota
| | - Ian D Hay
- Division of Endocrinology, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, Minnesota
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