Scrotal skin metastasis from rectum adenocarcinoma

Metastasis of Rectal Adenocarcinoma to the Penis and Scrotum in an Adult

We present a unique case of a 74-year-old male with rectal adenocarcinoma and subsequent cutaneous metastases to the penis and scrotum. Although penile and scrotal metastases have been described separately in the literature, no report has documented simultaneous metastases to both sites. Here, we describe our patient's clinical course, treatment, and intervention throughout the timeline of his disease. We also discuss the presentation, evaluation, management, and prognosis of cutaneous metastasis to the penis and scrotum.

A cutaneous metastasis of unresectable rectal adenocarcinoma: A case report and literature review

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Colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the fourth leading cause of cancer death in the world.

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Approximately, 0.8% of patients will present with skin lesion as the first sign of a silent internal malignancy as skin metastasis without visceral metastasis is rare in CRC.

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A comprehensive literature review (including clinical features of patients, management, and outcome) covering all reported cases of cutaneous metastasis secondary to rectal cancer was included for better understanding of the disease.

Background

Colorectal cancer is ranked third among the most commonly diagnosed malignancies and fourth among the leading causes of cancer death in the world. However, only a few case reports are found in the literature regarding skin metastasis originating from rectal cancer, which usually shows widespread disease and poor prognosis. Approximately, 0.8% of the patients will have skin lesion as the first indication of a silent internal malignancy, which is rare.

Case report

We report a complicated case of a 45-year-old male patient who referred to our highly specialized governmental hospital for diversion loop colostomy as well as biopsies of rectal and inguinal skin areas followed by palliative radiation therapy to the pelvis. Histopathological exam of rectal biopsies revealed moderately differentiated rectal adenocarcinoma, while the skin of the right inguinal area showed metastatic cutaneous rectal adenocarcinoma. Unfortunately, palliative radiation therapy was not started as the patient passed away secondary to respiratory failure which ended by cardiopulmonary arrest.

Conclusion

A patient who is having new or evolving skin lesions with an oncology history should be well investigated as cutaneous metastasis is a strong possibility.

Interesting Case of Skin Metastasis in Colorectal Cancer and Review of Literature

Skin metastasis is a complication rarely seen after curative resection for colorectal cancer and chemotherapy. The article describes a metachronous case of skin metastasis after curative resection. This article is presented to illustrate that genetic and molecular profiling of carcinoma is a must for diagnosis of aggressive biological behavior and that skin metastasis is usually a harbinger of adverse outcome.

Penile and multiple cutaneous metastases over the pubic region from a rectal adenocarcinoma: An uncommon case

Synchronous penile and multiple cutaneous metastases over the pubic region from a rectal adenocarcinoma are rare, and they usually indicate widespread disease. The most frequent localization of cutaneous metastases is the postoperative scar. Simultaneous penile and pubic region metastases are extremely uncommon. Although a penile metastasis from a rectal adenocarcinoma has been reported, synchronous metastases over the penile and pubic area have not been reported previously. We present a case of penile and multiple cutaneous metastases over the pubic region from a rectal adenocarcinoma along with a brief review of the literature. To the best of our knowledge, this is the first such case reported to present with simultaneous penile and multiple cutaneous metastases.

Cutaneous Metastasis of Rectal Cancer: A Case Report and Literature Review

Cutaneous metastasis of rectal cancer is rare. It typically indicates widespread disease and poor prognosis. We report an exceedingly rare case of rectal cancer with metastasis to the skin and review the literature on cutaneous metastasis of rectal cancer. A 47-year-old man presented with stage IV unresectable adenocarcinoma of the rectum and received palliative chemoradiation for local pain control. About a year later he developed extensive skin lesions involving the genital area, bilateral groin, and perineum. Biopsy specimen showed mucinous adenocarcinoma compatible with rectal origin. Palliative treatment with radiation therapy was initiated. The patient responded well to treatment and is still alive more than a year after diagnosis of cutaneous metastasis. Surgeons should maintain strong suspicion of cutaneous metastases when patients with rectal cancer have new or evolving skin lesions.