1
|
Irvine J, McKenna L, Wylie G. Cutaneous metastases as the presenting feature of lung cancer. BMJ Case Rep 2023; 16:e255225. [PMID: 38142053 DOI: 10.1136/bcr-2023-255225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2023] Open
Abstract
Lung cancer is the second most common cancer diagnosed in men and women worldwide with the highest mortality. A rare site of metastases for lung cancer is the skin. Typically, the diagnosis is secure prior to developing cutaneous metastases. We present a case of a man in his mid-70s who presented to dermatology with cutaneous metastases. We outline the presentation, diagnostic workup and management of this case. We also review the literature of cutaneous metastases in lung cancer; highlighting the clinical need for a timely accurate diagnosis and the implication in terms of prognosis.
Collapse
Affiliation(s)
- James Irvine
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Louise McKenna
- Dermatology Department, Queen Elizabeth University Hospital, Glasgow, UK
| | - Grant Wylie
- Dermatology Department, Queen Elizabeth University Hospital, Glasgow, UK
| |
Collapse
|
2
|
Dumlao JKG, Cubillan ELA, Villena JPDS. Clinical and Histopathologic Profile of Patients with Cutaneous Metastasis in a Tertiary Hospital in the Philippines. Dermatopathology (Basel) 2022; 9:392-407. [PMID: 36547220 PMCID: PMC9777325 DOI: 10.3390/dermatopathology9040046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/24/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Cutaneous metastases represent 2% of skin tumors, with an overall incidence of 5.3%. Although rare, clinical presentations of cutaneous metastasis vary and can be mistaken for benign and malignant skin conditions. METHODOLOGY This was a descriptive, retrospective review of all patients diagnosed with cutaneous metastasis seen at the Department of Dermatology from January 2013 to December 2019. Clinical and histopathologic data from the patients were collated from medical records, and slides were retrieved for review. RESULTS A total of 115 patients were included and 122 slides reviewed. There were more female than males, the mean age was 52.3 ± 14.0 years of age. The most common primary cancer was the breast, and accordingly, the most common location was anterior chest. Among the 122 slides reviewed from 104 patients, the most common histologic type was adenocarcinoma (72.1%), and showed the infiltrative pattern (26.2%). Other histologic types seen were melanoma (13.1%), leukemic infiltrates (11.5%), squamous origin (2.5%), and epithelioid sarcoma (0.8%). Lymphovascular invasion and dermal sclerosis were observed. Immunohistochemical stains were performed in only 13.9% of the cases. There was a high concurrence of the clinical with the histopathologic diagnosis (95.6%). CONCLUSION Although rare, patients with cutaneous metastasis may present in dermatology clinics. Knowledge of clinical features and low threshold for doing biopsies may prove useful for these patients. Similarly, dermatopathologists should be able to recognize histologic features of cutaneous metastasis morphologically. Histologic features may be subtle and may be reminiscent of benign inflammatory conditions, hence judicious use of immunohistochemical staining is recommended.
Collapse
|
3
|
González-Martínez S, Pizarro D, Pérez-Mies B, Caniego-Casas T, Rodríguez-Peralto JL, Curigliano G, Cortés A, Gión M, Cortés J, Palacios J. Differences in the Molecular Profile between Primary Breast Carcinomas and Their Cutaneous Metastases. Cancers (Basel) 2022; 14:cancers14051151. [PMID: 35267459 PMCID: PMC8909188 DOI: 10.3390/cancers14051151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 01/01/2023] Open
Abstract
Simple Summary The development of new strategies for the management of cutaneous metastases is a major clinical challenge because of the poor prognosis. To advance in this field, a better understanding of the molecular alterations involved in the metastatic process is needed. In the present study, the clinicopathological characteristics of breast cancer that develop cutaneous metastases were analyzed and the molecular differences between primary breast tumors and their corresponding cutaneous metastases were compared. We observed that the surrogate molecular type of breast cancer with an increased risk to metastasize to the skin was triple negative. In total, 48.5% of the cutaneous metastases presented some additional molecular alteration with respect to the primary tumor. However, no characteristic mutational pattern related to skin metastasis development was observed. Identifying the genes involved in the development of cutaneous metastases is important to gain insights into the biology of the disease and to identify possible diagnostic and therapeutic biomarkers. Abstract Background: The characterization of molecular alterations of primary breast carcinomas (BC) and their cutaneous metastases (CM) to identify genes involved in the metastatic process have not yet been completely accomplished. Methods: To investigate the molecular alterations of BC and their CM, a total of 66 samples (33 BC and 33 CM) from 33 patients were analyzed by immunohistochemical and massive parallel sequencing analyses. In addition, the clinicopathological characteristics of patients and tumors were analyzed. Results: Triple negative (TN) BCs were overrepresented (36.4%) among tumors that developed CM. A change of tumor surrogate molecular type in metastases was found in 15% of patients and 48.5% of the CM presented some additional molecular alteration with respect to the primary tumor, the most frequent were amplification of MYC and MDM4, and mutations in TP53 and PIK3CA. Survival was related to histological grade, tumor surrogate molecular type and TP53 mutations in the univariate analysis but only the tumor surrogate molecular type remained as a prognostic factor in the multivariate analysis. Conclusions: The TN molecular type has a greater risk of developing skin metastases. There are phenotypic changes and additional molecular alterations in skin metastases compared to the corresponding primary breast tumors in nearly half of the patients. Although these changes do not follow a specific pattern and varied from patient to patient, they could impact on the treatment. More studies with larger patient and sample cohorts are needed.
Collapse
Affiliation(s)
- Silvia González-Martínez
- Clinical Research, Ramón y Cajal Hospital, 28034 Madrid, Spain;
- “Contigo Contra el Cáncer de la Mujer” Foundation, 28010 Madrid, Spain
| | - David Pizarro
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
| | - Belén Pérez-Mies
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
- Department of Pathology, Ramón y Cajal University Hospital, 28034 Madrid, Spain
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- Faculty of Medicine, University of Alcalá, 28801 Madrid, Spain
| | - Tamara Caniego-Casas
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
| | - José Luis Rodríguez-Peralto
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- I+D Institute, 12 de Octubre University Hospital, 28041 Madrid, Spain
- Department of Pathology, Medical School, Complutense University, 28040 Madrid, Spain
| | - Giuseppe Curigliano
- European Institute of Oncology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), 20141 Milan, Italy;
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Alfonso Cortés
- Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain; (A.C.); (M.G.)
| | - María Gión
- Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain; (A.C.); (M.G.)
| | - Javier Cortés
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
- International Breast Cancer Center (IBCC), Quironsalud Group, 08017 Barcelona, Spain
- Medica Scientia Innovation Research, 08007 Barcelona, Spain
- Medica Scientia Innovation Research, Ridgewood, NJ 07450, USA
- Correspondence: (J.C.); (J.P.)
| | - José Palacios
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
- Department of Pathology, Ramón y Cajal University Hospital, 28034 Madrid, Spain
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- Faculty of Medicine, University of Alcalá, 28801 Madrid, Spain
- Correspondence: (J.C.); (J.P.)
| |
Collapse
|
4
|
Rajeev A, Elzawahry A, Rakhra S, Singisetti K. OUP accepted manuscript. J Surg Case Rep 2022; 2022:rjac139. [PMID: 35382005 PMCID: PMC8975578 DOI: 10.1093/jscr/rjac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/15/2022] [Indexed: 11/14/2022] Open
Abstract
Cutaneous metastasis from the primary breast carcinoma occurs when the disease is wide spread and can present as skin infection especially in a previous well-healed scar. If the secondary deposit is over a total knee incisional site it can mimic peri-prosthetic joint infection. We report a rare and unusual case of a woman who presented with clinical signs and symptoms of a peri-prosthetic total knee replacement which on biopsy turned out to be cutaneous metastasis from a previously treated breast cancer. Chronic granulation tissue in a total joint incisional scar may present as peri-prosthetic joint infection. A good history taking and clinical examination with specimens from the skin lesions send for both microbiology and histopathology is recommended to arrive at an early and accurate diagnosis.
Collapse
Affiliation(s)
- Aysha Rajeev
- Correspondence address. Queen Elizabeth Hospital, Gateshead Health Foundation NHS Trust, Sheriff Hill, Gateshead, NE9 6SX, UK. Tel: 00447414262665; E-mail:
| | - Ahmed Elzawahry
- Queen Elizabeth Hospital, Gateshead Health Foundation NHS Trust, Sheriff Hill, Gateshead NE9 6SX, UK
| | - Simren Rakhra
- Queen Elizabeth Hospital, Gateshead Health Foundation NHS Trust, Sheriff Hill, Gateshead NE9 6SX, UK
| | - Kiran Singisetti
- Queen Elizabeth Hospital, Gateshead Health Foundation NHS Trust, Sheriff Hill, Gateshead NE9 6SX, UK
| |
Collapse
|
5
|
Betlloch-Mas I, Soriano-García T, Boira I, Palazón JC, Juan-Carpena G, Sancho-Chust JN, Chiner E. Cutaneous Metastases of Solid Tumors: Demographic, Clinical, and Survival Characteristics. Cureus 2021; 13:e19970. [PMID: 34984130 PMCID: PMC8714347 DOI: 10.7759/cureus.19970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cutaneous metastasis (CM), while uncommon, is usually an indicator of poor prognosis. With cancer patients living longer, the incidence of CM has increased, which justifies its analysis. OBJECTIVES The objective of this study was to carry out a descriptive study of CM diagnosed for 18 years in a dermatology department of a tertiary care hospital and to assess the epidemiological, clinical, and histological variables that condition them, as well as data on their survival and prognosis. METHODS We performed a descriptive study of cases of CM diagnosed over 18 years in the dermatology department of a tertiary referral hospital analyzing the following variables: patient age and sex, site of primary neoplasm, pathochronology, survival time, histological findings, immunohistochemical markers, the anatomical area affected, the clinical appearance of the metastasis, therapeutic plan, and existence of metastases in other regions. We checked normal distribution using the Kolmogorov-Smirnov test and then compared the quantitative variables using the Student's t-test (unpaired samples), Mann-Whitney test (non-normal distribution), analysis of variance (ANOVA; for more than two groups), and categorical variables using the chi-square or Fisher's exact test. RESULTS We included 37 cases (20 men and 17 women), of whom 32 had died. The mean age was 62 ± 15 years. CM detection was defined early in 8% of cases, synchronous in 32%, and metachronous in 60%. The most frequent primary tumor sites were lungs (24%), breasts (21%), and bladders (11%). Most metastases were solitary. The most frequent locations for CM were the scalp, trunk, armpits, and groin. Most lesions had a nodular presentation (81%). Squamous cell carcinoma and adenocarcinoma showed the same frequency in lung cancer CM. Breast cancer leading to CM was the most common invasive ductal carcinoma. The most aggressive cases, with the worst survival, originated in lung neoplasms. Therapeutic management for most patients involved surgery in combination with other procedures. The only difference detected between the lung and breast cancer CM was the predominance of lung tumors in men (89%) and breast tumors in women compared with metastases from other sites; breast cancer CM manifested more frequently as plaques and less frequently as nodules (p < 0.05) and was less frequently associated with multisystemic metastasis. In lung cancer CM, time from tumor diagnosis to CM occurrence was shorter (p < 0.01) and multisystemic metastasis was more frequent than in CM of other tumors. CONCLUSIONS CM tends to affect patients aged above 60 years and arises predominantly from lung cancer in men and breast cancer in women. The most typical locations are the chest and scalp, and the appearance is usually nodular. Survival after CM detection is low, particularly in lung cancer CM.
Collapse
Affiliation(s)
| | | | - Ignacio Boira
- Pulmonology, Hospital Universitario San Juan Alicante, Alicante, ESP
| | | | | | | | - Eusebi Chiner
- Pulmonology, Hospital Universitario San Juan Alicante, Alicante, ESP
| |
Collapse
|
6
|
Supekar BB, Tomar SS, Wankhade VH, Bhushan R, Singh RP, Bhat DM. Clinical Spectrum of Cutaneous Malignancies in Central India: A Retrospective Study. Indian J Dermatol 2021; 66:284-290. [PMID: 34446952 PMCID: PMC8375545 DOI: 10.4103/ijd.ijd_543_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Cutaneous malignancies account for 1%–2% of all the diagnosed cancers in India. Nonmelanoma skin cancers (NMSCs) include basal cell carcinomas (BCC) and squamous cell carcinomas (SCC). Others include melanoma, cutaneous lymphomas, and sarcomas. Exposure to ultraviolet (UV) rays is the most important risk factor associated with skin malignancies, although various other factors are also implicated. Aims and Objectives: The aims of this work were to study clinical spectrum with age and sex distribution of cutaneous malignancies and metastasis; to study clinicopathological variants of each type of cutaneous malignancies; and to study the risk factors associated with cutaneous malignancies. Patients and Methods: It was a retrospective analysis of clinically and biopsy proven cases of cutaneous malignancies from January 1, 2016 to January 31, 2018. Medical records of patients were assessed with respect to demographic information, clinical examination, dermoscopy, and histopathology. Statistical analysis was done using mean, proportion, and percentage. Results: Sixty-six cases with cutaneous malignancies were recruited. There was female preponderance. The most common age group affected was 60–70 years. BCC was the most common malignancy (41%) followed by SCC (30%), malignant melanoma (9%), and cutaneous T-cell lymphoma (1.5%). Head and neck was the most common site involved. The most common clinical type of both BCC and SCC was the nodular type. Acral lentiginous was the most frequent subtype of melanoma reported. The most common predisposing for NMSCs was prolonged sun exposure (46%). Conclusion: This study highlights an increasing trend of NMSCs with female preponderance. Head and neck is the most common site involved. Increased risk of NMSCs is seen with increased sun exposure and predisposed genetic conditions. T-cell lymphoma was common than B-cell type. The most common internal malignancy to cause cutaneous metastasis was breast carcinoma.
Collapse
Affiliation(s)
| | - Suyash Singh Tomar
- Department of Dermatology, Venereology and Leprology, Government Medical College, Nagpur, Maharashtra, India
| | - Vaishali H Wankhade
- Department of Dermatology, Venereology and Leprology, Government Medical College, Nagpur, Maharashtra, India
| | - Ravi Bhushan
- Department of Dermatology, Venereology and Leprology, Government Medical College, Nagpur, Maharashtra, India
| | - Rajesh Pratap Singh
- Department of Dermatology, Venereology and Leprology, Government Medical College, Nagpur, Maharashtra, India
| | | |
Collapse
|
7
|
Abstract
We present the case of a 57-year-old woman diagnosed with stage 4 sarcomatoid carcinoma of the lung who concurrently developed a scalp lesion, thought to be a cyst, which continued to grow and ulcerate. Excision revealed a rare case, only four previously reported in the literature, of metastatic sarcomatoid carcinoma of the lung. While a very unusual case, we would like to emphasise the importance of considering skin metastases when presented with unusual skin lesions, and importantly listening to the patient's concerns, showing empathy and respecting their autonomy and referring to an appropriate specialist when considering the management of what may seem to be a minor skin report.
Collapse
Affiliation(s)
| | - Colin Moyes
- Pathology Department, Forth Valley Royal Hospital, Larbert, Falkirk, UK
| | - Andrew Malyon
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, Scotland, UK
| |
Collapse
|
8
|
Droubi S, Aqsa A, Rehan M, Dhar M. Rapid Response of Breast Cancer Cutaneous Metastasis to Single-Agent Palbociclib: A Case Report. Chemotherapy 2021; 65:1-3. [PMID: 33540405 DOI: 10.1159/000512499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/17/2020] [Indexed: 11/19/2022]
Abstract
Palbociclib is a cyclin-dependent kinase (CDK) 4/6 inhibitor. Palbociclib combined with endocrine therapy has shown promising results in hormone-receptor-positive (HR+) and human epidermal growth factor receptor-negative (HER-2-) breast cancer progression. We present a case of a woman with a history of infiltrating lobular cancer of the left breast, status post modified radical mastectomy 6 years prior, presenting with nodular erythematous lesions on the left arm and back. Histopathological examination confirmed the diagnosis of recurrent metastatic breast adenocarcinoma. She had complete resolution of cutaneous metastasis with 1 cycle of Palbociclib. We believe our case is unique as the resolution of cutaneous metastasis with 1 cycle of single-agent Palbociclib is rare. Furthermore, it highlights the importance of considering cutaneous metastasis as a possibility in patients with prior history of primary internal malignancy.
Collapse
Affiliation(s)
- Sami Droubi
- Department of Internal Medicine, Staten Island University Hospital, New York, New York, USA,
| | - Anum Aqsa
- Department of Internal Medicine, Staten Island University Hospital, New York, New York, USA
| | - Maryam Rehan
- Department of Hematology-Oncology, Staten Island University Hospital, New York, New York, USA
| | - Meekoo Dhar
- Department of Hematology-Oncology, Staten Island University Hospital, New York, New York, USA
| |
Collapse
|
9
|
Kapatia G, Sahu S, Rohilla M, Gupta P, Gupta N, Srinivasan R, Rajwanshi A, Dey P. Clinical and morphological spectrum of cutaneous metastases on cytology: A study of 225 cases. Cytopathology 2020; 32:233-237. [PMID: 33128312 DOI: 10.1111/cyt.12934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Any type of cutaneous metastasis indicates dismal outcome of the disease. Skin is an unusual location for metastatic deposits from any tumour and has an incidence of about 0.8%-5%. Fine needle aspiration cytology (FNAC) helps in the rapid diagnosis of metastasis with minimum pain. AIM To study the cytomorphological spectrum of cutaneous metastasis on FNAC. MATERIAL AND METHODS A total of 225 patients with diagnosis of cutaneous metastasis on cytology were analysed. May-Grünwald Giemsa and haematoxylin-eosin-stained smears were studied and examined for the cytomorphological spectrum of cutaneous metastasis. Cell block was prepared in a few cases. In a subset of cases, immunohistochemistry was done to pinpoint the primary. RESULTS Amongst the 225 patients studied, the mean age was 53.9 years. There was female preponderance with 125 females and 100 males. The commonest site was abdominal wall (n = 89) followed by chest wall (n = 60). The most common type of metastasising tumour was adenocarcinoma. CONCLUSION Clinicians and pathologists must be aware of the clinico-morphological spectrum of cutaneous metastasis for instant diagnosis followed by prompt management.
Collapse
Affiliation(s)
- Gargi Kapatia
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Saumya Sahu
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Manish Rohilla
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Nalini Gupta
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Pranab Dey
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| |
Collapse
|
10
|
Padden S, Abraham E, Viscosi E, Habin K, Lundquist D. Cutaneous Metastases: A Case Study on Clinical Care for Patients. Clin J Oncol Nurs 2020; 24:320-323. [DOI: 10.1188/20.cjon.320-323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
11
|
Alkan A, Kayış D, Çelik SY, Uylaş S, Demir Pektaş S, Oral Tapan Ö, Gökdoğan O, Türkkan G, Genç S, Tanrıverdi Ö. Management of a glottic squamous cell carcinoma with cutaneous metastasis. J Oncol Pharm Pract 2020; 26:1495-1498. [PMID: 32028840 DOI: 10.1177/1078155219900782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Oral cavity malignancies constitute 30% of head and neck cancers. The most common distant metastatic sites of glottic carcinoma are usually lung, liver and bone. Although the cutaneous metastasis of head and cancers have been reported with an incidence of 0.7-2.4%, skin metastasis of glottic carcinoma is extremely rare. CASE REPORT A 69-year-old male patient was admitted to the emergency department with hemoptysis, dyspnea, weakness in lower extremities and difficulty in swallowing. There were subcutaneous lesions with a diameter of 2-5 cm in the scalp, posterior chest wall, nose and abdomen. In addition, there was an ulcerating, painful mass on the right lateral part of the tongue. The biopsy of lesions on tongue and skin revealed a glottic squamous cell carcinoma with cutaneous metastasis.Management and outcome: The patient was treated with cisplatin 50 mg/m2 on day 1, cetuximab 500 mg/m2 on day 1 and 5-fluorouracil 1000 mg/m2 daily on days 1 and 2, repeated every two weeks. After the first cycle of chemotherapy, the lesions on the skin regressed and dysphagia improved. DISCUSSION There are limited data about the incidence, diagnostic measures and treatment modalities of glottic cancer with cutaneous metastasis. Our case could provide an important experience to literature by its atypical presentation and treatment-sensitive nature.
Collapse
Affiliation(s)
- Ali Alkan
- Medical Oncology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Deniz Kayış
- Internal Medicine, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Serkan Yaşar Çelik
- Pathology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Selçuk Uylaş
- Medical Oncology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Suzan Demir Pektaş
- Dermatology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Özge Oral Tapan
- Chest Diseases, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Ozan Gökdoğan
- Otorhinolaryngology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Görkem Türkkan
- Radiation Oncology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Sebahat Genç
- Chest Diseases, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Özgür Tanrıverdi
- Medical Oncology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| |
Collapse
|
12
|
Choi ME, Jung CJ, Lee WJ, Won CH, Chang SE, Choi JH, Lee MW. Clinicopathological study of Korean patients with cutaneous metastasis from internal malignancies. Australas J Dermatol 2019; 61:e139-e142. [PMID: 31436312 DOI: 10.1111/ajd.13135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Myoung Eun Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chang Jin Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jee Ho Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
13
|
Abstract
Cutaneous metastasis portends a poor prognosis. Therefore, a high clinical index of suspicion is necessary so that a clinician knows how to recognize the presentation of a cutaneous metastasis, while the pathologist must know the appropriate stains to order. In this review, the authors summarize the common and uncommon ways that these tumors will present. Frequently a metastatic cancer will present as a firm red nodule or as a plaque, ulcer, or papule. Less commonly they will present with a clinical clue that can alert a clinician to a likely diagnosis; these manifestations include alopecic, vesicular, blue color, sclerodermoid, acrochordon-, or pellagra-like.
Collapse
Affiliation(s)
- Evan Alexander Choate
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alexander Nobori
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Scott Worswick
- Department of Dermatology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Ezralow Tower, Suite 5301, Los Angeles, CA 90033-9174, USA.
| |
Collapse
|
14
|
Mendonça-Sanches M, Rolim I, Cabeçadas J, Rafael M. An Unusual Presentation of Metastatic Breast Carcinoma. Eur J Case Rep Intern Med 2019; 6:001089. [PMID: 31139586 PMCID: PMC6499091 DOI: 10.12890/2019_001089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 03/18/2019] [Indexed: 11/14/2022] Open
Abstract
Cutaneous metastasis from a carcinoma is a relatively uncommon phenomenon. Prompt diagnosis is crucial, as it will have future implications, particularly regarding prognosis and treatment. Skin metastases can be suspected and recognized earlier through physical examination than metastases in other organs or systems. However, they can be a diagnostic challenge due to the variable clinical presentation. This case highlights the importance of having a high index of suspicion for cutaneous metastases, especially in patients with a previous history of cancer.
Collapse
Affiliation(s)
| | - Inês Rolim
- Pathology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - José Cabeçadas
- Pathology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Margarida Rafael
- Dermatology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| |
Collapse
|
15
|
Kaplan V, Morales C, Bobadilla F, Fernández J, Segovia L, Vera V, Sanhueza I. Epidemiologic and Histopathologic Characterization of Cutaneous Metastases in Patients Who Visited 2 Hospitals in Santiago de Chile Between 2005 and 2017. Actas Dermo-Sifiliográficas (English Edition) 2019. [DOI: 10.1016/j.adengl.2019.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
16
|
Kaplan V, Morales C, Bobadilla F, Fernández J, Segovia L, Vera V, Sanhueza I. Epidemiologic and Histopathologic Characterization of Cutaneous Metastases in Patients Who Visited 2 Hospitals in Santiago de Chile Between 2005 and 2017. Actas Dermosifiliogr (Engl Ed) 2018; 110:220-226. [PMID: 30577946 DOI: 10.1016/j.ad.2018.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/12/2018] [Accepted: 07/15/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Cutaneous metastases (CMs) account for 2% of skin tumors and their incidence varies between 0.7% and 9% in patients with cancer. The objective of this study was to describe and analyze the demographic, clinical, and histopathologic characteristics of CM in patients who visited 2 hospitals in the Santiago de Chile metropolitan region. MATERIAL AND METHOD We performed a retrospective, descriptive, analytical, observational, cross-sectional study. We reviewed the pathology reports, patient records, pathology slides, and dates of death for diagnosed cases of CM from the anatomic pathology departments of 2 hospitals in the Santiago de Chile metropolitan region between 2015 and 2017. RESULTS Ninety-six patients with CM were included in the study; 60.42% were women and 39.58% were men. The mean (SD) age was 67.95 (13.74) years, with a range of 28 to 96 years. The most common primary tumor was melanoma in 27.08% of cases (n=26), followed by breast cancer (18.75%, n=18), and adenocarcinoma (15.63%, n=15). The median time between diagnosis of the tumor and cutaneous metastasis was 9 months. Patients with CM of melanoma had a higher survival rate than patients with metastasis of other primary tumors (P<.05). A histopathologic study of 91 slides showed that diffuse infiltration of the tissue with tumor cells was the most common pattern and vascular invasion was rare. CONCLUSIONS The results are similar to those found worldwide. CM is a rare manifestation of internal tumors. It presents mainly at an advanced age and is equally prevalent in both sexes.
Collapse
Affiliation(s)
- V Kaplan
- Departamento de Dermatología y Venereología, Universidad de Chile, Santiago, Chile.
| | - C Morales
- Servicio de Anatomía Patológica, Hospital Clínico de la Universidad de Chile, Santiago, Chile
| | - F Bobadilla
- Servicio de Dermatología y Venereología, Hospital Barros Luco Trudeau, Santiago, Chile
| | - J Fernández
- Servicio de Dermatología y Venereología, Hospital San José, Santiago, Chile
| | - L Segovia
- Servicio de Anatomía Patológica, Hospital Barros Luco Trudeau, Santiago, Chile
| | - V Vera
- Departamento de Nutrición, Universidad de Chile, Santiago, Chile
| | - I Sanhueza
- Facultad de Medicina, Universidad de Chile, Santiago, Chile
| |
Collapse
|
17
|
Gupta B, Mallya V, Jain S, Agarwal PN. Utility of FNAC in Dermatological Manifestations of Metastatic Cancer with the Review of the Literature. J Cytol 2018; 35:237-241. [PMID: 30498297 PMCID: PMC6210811 DOI: 10.4103/joc.joc_158_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives Cutaneous metastasis (CM) though rare, indicates a terminal event in any malignancy and has a grave outcome. The present study reiterates the role of fine needle aspiration cytology (FNAC) in the diagnosis of metastatic cutaneous nodules. Materials and Methods From 2015 to 2017, the department received 22,000 cases for FNAC. Among these cases, aspirations from the skin and subcutaneous region were performed on 6,083 cases. After excluding primary tumors of skin/subcutis, 25 cases on cytology were suggestive of metastasis. Clinicoradiological and histopathological profiles in these cases were reviewed. Results Among these 25 patients, the male to female ratio was 1:1.09 (F, 12; M, 13) in the age group of 18-72 years. Most common primary malignancy in females was of breast and in males was gall bladder. The most common manifestation was a palpable skin nodule, with the abdominal wall being the predominant site. The most common diagnosis, on cytology, was metastatic adenocarcinoma. Conclusion FNAC is a minimally invasive method, which aides in prompt detection and appropriate management of cases presenting with skin nodules and clinically unsuspected of malignancy. Whereas in known primary tumor, it indicates dismal prognosis by diagnosing CM; in cases with unknown primaries, cytomorphology in conjunction with clinicoradiological findings often gives a clue to the possible primary site.
Collapse
Affiliation(s)
- Barkha Gupta
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Varuna Mallya
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Shyama Jain
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - P N Agarwal
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
| |
Collapse
|
18
|
Torraca PDFS, Castro BCD, Hans G, Lima AMD. Cutaneous metastases in a patient with no previous diagnosis of cancer: diagnostic challenge. An Bras Dermatol 2018; 92:47-49. [PMID: 29267444 PMCID: PMC5726675 DOI: 10.1590/abd1806-4841.20175870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 09/26/2016] [Indexed: 12/26/2022] Open
Abstract
On rare occasions, skin lesions are the first local of metastatic manifestation
of internal malignancies. In case of no previous diagnosis of these tumors, the
approach of suspicious skin lesions becomes a challenge, especially in
differentiating cutaneous metastases and adnexal primary neoplasms. Currently,
besides epidemiologic, dermoscopic and histopathologic aspects, the evaluation
also integrates immunohistochemical exams and cell markers such as p40 and p63,
highly specific for skin metastases. This article describes the case of
cutaneous metastases as the sole obvious sign of breast cancer in a previously
asymptomatic woman. The diagnosis was made by the finding of neoplastic cells in
the dermis and immunohistochemistry compatible with ductal carcinoma.
Collapse
Affiliation(s)
- Pedro de Freitas Silva Torraca
- Department of Internal Medicine of the Faculdade de Medicina da Universidade Federal de Mato Grosso do Sul (Famed-UFMS) - Campo Grande (MS), Brazil
| | - Bruna Corrêa de Castro
- Dr. Günter Hans Department of Dermatology, at Hospital Universitário da Universidade Federal de Mato Grosso do Sul (NHU-UFMS) - Campo Grande (MS), Brazil
| | - Günter Hans
- Dr. Günter Hans Department of Dermatology, at Hospital Universitário da Universidade Federal de Mato Grosso do Sul (NHU-UFMS) - Campo Grande (MS), Brazil
| | - Alexandre Moretti de Lima
- Dr. Günter Hans Department of Dermatology, at Hospital Universitário da Universidade Federal de Mato Grosso do Sul (NHU-UFMS) - Campo Grande (MS), Brazil
| |
Collapse
|
19
|
Abstract
Sarcomatoid carcinoma is a biphasic neoplasm composed of highly complex, intimately admixed malignant epithelial and mesenchymal elements. We herein report a rare case of cutaneous metastasis of pulmonary sarcomatoid carcinoma that contains liposarcomatous, rhabdosarcomatous and chondrosarcomatous heterologous differentiation, and review relevant literatures to lead to a better understanding of this rare but highly aggressive tumor.
Collapse
Affiliation(s)
- Xuezhu Xu
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
| | - Mao Lin
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
| | - Shengyi Wang
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
| | - Zeyu Jin
- b The Clinical Medical College, Shanghai Jiao Tong University , Shanghai , China
| | - Shixin Han
- c Department of Dermatology , First Affiliated Hospital of Dalian Medical University , Dalian , China
| | - Xia Liu
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
| | - Yuxue Gao
- a Department of Dermatology , the Second Hospital of Dalian Medical University , Dalian , China
| |
Collapse
|
20
|
Graham PM, Kolb LJ, Mortazie M, Ramirez J, Fivenson D. An unusual acneiform presentation representing secondary squamous cell carcinoma of the skin. JAAD Case Rep 2016; 2:168-70. [PMID: 27222879 PMCID: PMC4864098 DOI: 10.1016/j.jdcr.2016.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Paul M. Graham
- Department of Dermatology, St Joesph Mercy Dermatology, Ann Arbor, Michigan
- Correspondence to: Paul M. Graham, DO, St Joseph Mercy Hospital, Ann Arbor, Michigan.St Joseph Mercy Hospital SystemAnn ArborMichigan
| | | | - Michael Mortazie
- Department of Dermatology, St Joesph Mercy Dermatology, Ann Arbor, Michigan
| | - James Ramirez
- Department of Dermatopathology, St Joesph Mercy Dermatology, Ann Arbor, Michigan
| | - David Fivenson
- Department of Dermatology, St Joesph Mercy Dermatology, Ann Arbor, Michigan
| |
Collapse
|
21
|
Abstract
Context: Cutaneous metastasis from head and neck cancer is uncommon and it is seen from laryngeal cancer. Cutaneous metastasis from the base of tongue is relatively rare. Case Report: A 55-year-old male, who was a treated case of squamous carcinoma of the base of tongue presented with metastatic nodule on the skin of face and thigh. But, there was complete resolution of the tumor at the primary site. In the present case, clinically obvious cutaneous nodules with metastasis appeared soon after the completion of treatment with concurrent chemo-radiotherapy. The metastasis to the skin of face clinically appeared like an inflammatory lesion. Fine needle aspiration cytology confirmed the diagnosis of metastasis to skin at both the sites. Conclusion: Our case has highlighted that there could be associated occult skin metastasis at the time of diagnosis in squamous carcinoma of the base of tongue.
Collapse
Affiliation(s)
- Tashnin Rahman
- Department of Head and Neck Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India
| | | | - Anupam Sarma
- Department of Pathology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India
| | - Mahesh Kumar
- Department of Head and Neck Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India
| | - Amal C Kataki
- Department of Head and Neck Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India
| |
Collapse
|
22
|
|
23
|
Abstract
Skin metastases are rare in the routine clinical practice of dermatology, but are of major clinical significance because they usually indicate advanced disease. We reviewed the literature on skin metastasis regarding recent trends in clinical presentation and diagnosis of the most common cutaneous lesions. An extensive literature review was conducted using PubMed from May 26, 2011 to July 16, 2013 relating cutaneous metastases. Articles chosen for reference were queried with the following prompts: “Cutaneous metastases”, “clinical presentation”, “histological features”, and “immunohistochemistry”. Further searches included “treatment” and “management” options for “metastatic breast”, “metastatic colorectal”, “metastatic melanoma”, “metastatic lung”, and “hematologic cancers.” We also reviewed the literature on the current management of melanoma as a model for all cutaneous metastatic disease. Our own clinical findings are presented and compared to the literature. Additionally, we highlight the most useful immunohistochemical studies that aid in diagnoses. Several novel therapies and combination therapies such as electrochemotherapy, vemurafenib, and imiquimod will be discussed for palliative treatment of cancers that have been found to improve cutaneous lesions. We review these notable findings and developments regarding skin metastases for the general dermatologist.
Collapse
Affiliation(s)
- Christina Yin Bin Wong
- Department of Dermatology, Roswell Park Cancer Institute, University at Buffalo, Buffalo, New York, USA
| | | | | | | | | |
Collapse
|