Cutaneous metastasis of carcinoma lung: a rare cytological association
Keywords:
Lung Carcinoma, Skin metastasis, Fine Needle Aspiration Cytology,
Abstract
Skin metastasis is an uncommon presentation of cancer. Cutaneous metastases as initial manifestation of internal neoplasms, represent only 0.8% of total cases and implies, in general, a very advanced grade of the disease and short survival. Metastasis to the skin from lung cancer is less common than metastasis to other organs. The incidence of skin metastasis was 2.8% among all 579 cases of lung cancer. Large cell carcinoma showed the greatest tendency to spread to the skin and epidermoid carcinoma showed the least tendency. Back of the trunk was the most common site for metastatic cutaneous lesions. Almost all lesions ranged from 1 to 5 cm in diameter. Clinical manifestation of skin metastasis was nodular type in all the cases and was accompanied by metastasis to other organs at the time of clinical presentation. A slight response to combination chemotherapy was noted in only 5 cases of lung cancers, with most lesions being progressive. Median survival after skin involvement was approximately 4 months. The lung cancer metastasizes to the skin in 2.8–24% of the cases, generally in advanced stages of the disease, although in 7–19%, skin metastases appear as the first manifestation of the malignant disease. We hereby present a rare case of a male diagnosed with a lung cancer, whose first manifestation was the appearance of skin metastases.References
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19) Sariya D, Ruth K, Adams-McDonnell R, Cu-sack C, Xu X, Elenitsas R, et al. Clinicopathologic correlation of cutaneous metastases: experience from a cancer center. Arch Dermatol 2007;143:613-20.
20) Ambrogi V, Tonini G, Mineo TC. Prolonged survival after extracranial metastasectomy from synchronous resectable lung cancer. Ann Surg Oncol 2001;8:663-6
2) Rosen T. Cutaneous Metastases. Med Clin North A. 1980; 65: 885-900.
3) Lookingbill DP, Spangler N, Helm KF. Cuta-neous metastases in patients with metastatic carcinoma: a retrospective study of 4020 pa-tients. J Am Acad Dermatol 1993; 29:228-36.
4) Hidaka T, Ishii Y, Kitamura S. Clinical features of skin metastases from lung cancer. Intern Med 1996; 35: 459-62.
5) Coslett LM, Katlic MR. Lung cancer with skin metastasis. Chest. 1990; 97:757-9.
6) Dreizen S, Dhingra H, Chiuten D, Umsawasdi T, Valdivieso M. Cutaneous and subcutaneous metastases of lung cancer. Postgrad Med. 1986; 80:111-6.
7) Lookingbill DP, Spangler N, Sexton FM. Skin involvement as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients. J Am Acad Dermatol 1990; 22:19-26.
8) Marcoval J, Moreno A, Peyrí J. Cutaneous infiltration by cancer. J Am Acad Dermatol 2007; 57:577-80.
9) Perng DW, Chen CH, Lee YC, Perng RP. Cutaneous metastases of lung cancer: an ominous prognostic sign. Chin Med J 1996; 57:343-7.
10) Holland J, Gansler T, Pollock R, Weichselbaum R. Cancer Medicine. Danbury: B. C. Decker Incorporated; 2003; 32:345-7.
11) Chiu CS, Lin CY, Kuo TT, Kuan YZ, Chen MJ, Ho HC, et al. Malignant cutaneous tumors of the scalp: a study of demographic characteristics and histologic distributions of 398 Taiwanese patients. J Am Acad Dermatol 2007; 56:448-52.
12) Rubinstein R, Baredes S, Caputo J, Galati L, Schwartz R. Cutaneous metastatic lung cancer: Literature review and report of a tumor on the nose from a large cell undifferentiated carcinoma. Ear Nose Throat J 2000; 79:96-7.
13) Garcia-Arpa M, Rodriguez-Vazquez M, San-chez-Caminero P, Delgado M, Vera E, Romero G, et al. Digital acrometastasis. Actas Dermosifiliog. 2006; 97:334-6.
14) Saeed S, Keehn CA, Morgan MB. Cutaneous metastasis: a clinical, pathological, and immunohistochemical appraisal. J Cutan Pathol 2004;1:419-30.
15) 15.Azoulay S, Adem C, Pelletier F, Barete S, Frances C, Capron, F. Skin metastases from unknown origin: role of immunohistochemistry in the evaluation of cutaneous metastases of carcinoma of unknown origin. J Cutan Pathol 2005; 32: 561-6.
16) Jerome Marson V, Mazieres J, Groussard O, Garcia O, Berjaud J, Dahan M, et al. Expression of TTF-1 and cytokeratins in primary and secondary epithelial lung tumours: correlation with histological type and grade. Histopathology 2004;45:125-34.
17) Koca R, Ustundag Y, Kargi E, Numanoglu G, Altinyazar HC. A case with widespread cuta-neous metastases of unknown primary origin: Grave prognostic finding in cancer. Dermatol Online J 2005; 11:16-23.
18) Rosai J. Special techniques in surgical pathology. In: Rosai and Ackerman's Surgical Pathology. Ninth edn., Vol. 1. Mosby, Philadelphia, 2004, pp. 37-91.
19) Sariya D, Ruth K, Adams-McDonnell R, Cu-sack C, Xu X, Elenitsas R, et al. Clinicopathologic correlation of cutaneous metastases: experience from a cancer center. Arch Dermatol 2007;143:613-20.
20) Ambrogi V, Tonini G, Mineo TC. Prolonged survival after extracranial metastasectomy from synchronous resectable lung cancer. Ann Surg Oncol 2001;8:663-6
Published
2014-09-28
Section
Case Report
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