Crops of Papules and papulonodular plaques- An unusual presentation of cutaneous metastasis- A case report and literature review
Keywords:
Malignant epithelial neoplasm, metastasis, papulonodulesAbstract
Cutaneous Metastasis refers to a growth of neoplastic cells in the skin originating from an internal malignancy. Morphologically the metastasis could take multiple morphologies. We report a case of cutaneous metastasis in a female of age 34 years. She initially presented with a 2 years history of progressive appearance of multiple asymptomatic clusters of monomorphic papulonodular lesions widespread on her trunk, lower limbs and genitalia later developed dyspnoea and weight loss. Chest CT showed moderate pleural effusion and multiple lymphadenopathies and right sided lung mass/consolidation. Histopathological evidences of cutaneous biopsy revealed cutaneous metastasis consistent with the lung primary.ÂReferences
Mollet TW, Garcia CA, Koester G. Skin metastases from lung cancer. Dermatol Online J 2009;15:1.
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.
Song Z, Lin B, Shao L, et al. Cutaneous metastasis as an initial presentation in advanced non-small cell lung cancer and its poor survival prognosis. J Cancer Res Clin Oncol 2012;138:1613-7.
Giroux Leprieur E, Lavole A, Ruppert AM, et al. Factors associated with long-term survival of patients with advanced non-small cell lung cancer. Respirology 2012;17:134-42.
Sörenson S, Glimelius B, Nygren P, et al. A systematic overview of chemotherapy effects in non-small cell lung cancer. Acta Oncol 2001;40:327-39.
Hussein MR. Skin metastasis: a pathologist’s perspective. J Cutan Pathol 2010;37:e1-20.
Krathen RA, Orengo IF, Rosen T. Cutaneous metastasis: a meta-analysis of data. South Med J 2003;96:164-7.
Dreizen S, Dhingra HM, Chiuten DF, et al. Cutaneous and subcutaneous metastases of lung cancer. Clinical characteristics. Postgrad Med 1986;80:111-6.
Vila JM, Casanova Seuma JM, Portero L, et al. Skin metastasis as the lst manifestation of bronchogenic carcinoma. Arch Bronconeumol 1994;30:314-6.
Kovács KA, Hegedus B, Kenessey I, et al. Tumor type-specific and skin region-selective metastasis of human cancers: another example of the “seed and soil†hypothesis. Cancer Metastasis Rev 2013;32:493-9.
Schoenlaub P, Sarraux A, Grosshans E, et al. Survival after cutaneous metastasis: a study of 200 cases. Ann Dermatol Venereol 2001;128:1310-5.
Hidaka T, Ishii Y, Kitamura S. Clinical features of skin metastasis from lung cancer. Intern Med 1996;35:459-62.
Roberts PJ, Stinchcombe TE, Der CJ, et al. Personalized medicine in non-small-cell lung cancer: is KRAS a useful marker in selecting patients for epidermal growth factor receptor-targeted therapy? J Clin Oncol 2010;28:4769-77.
Douillard JY, Shepherd FA, Hirsh V, et al. Molecular predictors of outcome with gefitinib and docetaxel in previously treated non-small-cell lung cancer: data from the randomized phase III INTEREST trial. J Clin Oncol 2010;28:744-52.
Lynch TJ, Bell DW, Sordella R, et al. Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 2004;350:2129-39.
Mollet, TW, Garcia CA, Koester, G. Skin metastases from lung cancer. Dermatol Online J. 2009;15(5). [Cited 2015 Jan 1]. Available from: http://escholarship.org/uc/ item/9r83m6wj
Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol. 1993 Aug;29:228-36.
