Cutaneous metastasis- A marker of hidden malignancy with an atypical presentation of neck nodules: A diagnostic challenge
DOI:
https://doi.org/10.66344/jpad.v36i1.3355Keywords:
Cutaneous metastases, Dermatofibrosarcoma protuberance, ImmunohistochemistryAbstract
Cutaneous metastases are rare but an indicator of internal malignancies, often presents with a wide spectrum of clinical appearances that usually cause diagnostic confusion. We report a 67-year-old male who presented with an indurated plaque over the anterior neck for six months, initially observed as hyperpigmented skin changes that progressively evolved into a firm, sclerotic plaque, studded with multiple flesh-colored nodules with a cobblestone-like texture associated with itching and restricted neck mobility. Early clinical and histopathological evaluation favoured dermatofibrosarcoma protuberans; however, subsequent tissue examination revealed an infiltrative epithelial malignancy. Immunohistochemistry (IHC) showed positivity with cytokeratin and CK7, favouring the diagnosis of cutaneous metastasis. Comprehensive systemic workup identified gastric carcinoma with skeletal dissemination. This case highlights the deceptive presentation of metastatic skin disease and emphasizes the importance of reassessment and repeat biopsy in managing the atypical and recalcitrant cutaneous lesions.References
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