ABSTRACT
@#Cutaneous metastasis (CM) describes the spread of a distant primary tumor into the skin. The overall incidence of CM ranges from 5% to 10% with breast cancer having the highest rate in women. CM of breast carcinoma origin may manifest as erysipelas-like erythema on the chest, having distinct raised borders and edema due to lymphatic obstruction termed as carcinoma erysipeloides. In most cases, CM is recognized after the initial diagnosis of primary internal malignancy. However, in 0.6–1% of cases, CM served as the first presenting sign of malignancy. A 48-year-old female presented with multiple, erythematous patches, and plaques with clear-cut raised margins, some topped with violaceous pinpoint papules and nodules on the chest, abdomen, and back. No palpable breast mass was appreciated. There was noted nipple retraction and axillary lymphadenopathy. A 4-mm skin punch biopsy revealed nests of large pleomorphic cells on the papillary dermis admixed with mitotic figures and attempts of ductal formation. CK7 and CEA were positive. Results of ultrasonography and mammogram were highly suspicious of malignancy. Core needle biopsy of the breast mass revealed an invasive ductal carcinoma. In the context of an eczematous presentation on the chest area without palpable nodules or mass on breast examination, a diagnostic challenge is expected. Interestingly, our patient represents a small group of CM having cutaneous lesions as their primary manifestation. A high index of suspicion supplemented with proper clinicopathologic and radiologic correlation is crucial for the diagnosis of CM. A multidisciplinary referral is required for adequate management and overall survival rate.
Subject(s)
Breast NeoplasmsABSTRACT
Gestational trophoblastic tumors, an uncommon group of pregnancy-related neoplasms, should be considered in any premenopausal patient presenting with metastatic disease from an unknown primary. A raised hCG and exclusion of pregnancy are often the only requirement in this situation. Although a potentially curable condition, a late diagnosis and the extent of the metastatic disease often determine the prognosis. Here we describe two young women with metastatic GTN, the first presenting with a very unusual finger metastasis and the second with a rare large solitary lung lesion with brain metastasis.
ABSTRACT
El tratamiento correcto de carcinoma escamoso avanzado requiere de un manejo multidisciplinar entre cirujanos, anatomopatólogos, radioterapeutas y radiólogos. Los protocolos están claros cuando nos hallamos ante una enfermedad localizada, sin embargo, cuando la enfermedad es metastática no existe evidencia científica de los pasos a seguir. Presentamos una paciente con un carcinoma escamoso del ano con una única metástasis cutánea metacrónica que fue tratada con cirugía y radioterapia posterior con buena respuesta.
The right therapy of anal cancer needs a multidisciplinary management of surgeons, pathologists, radiotherapists and radiologist. The treatment of squamous cell carcinoma of the anal canal is well-known when the patient presents a locally disease, nevertheless, there is a lack of information with the advanced anal cancer. We report a case of a 74-year-old woman with a solitary methachronical cutaneous metastasis of anal cancer which responded perfectly to surgery and radiotherapy.
A correta terapêutica do câncer anal necessita de uma gestão multidisciplinar de cirurgiões, patologistas, radio terapeutas e radiologistas.O tratamento do carcinoma espinocelular do canal anal é bem conhecido quando o paciente apresenta uma doença local, porém, há uma falta de informação sobre o câncer anal avançado. Relatamos o caso de uma mulher de 74 anos com metástase cutânea metacrônica solitária de câncer anal que respondeu perfeitamente à cirurgia e à radioterapia.
Subject(s)
Humans , Female , Aged , Anal Canal/surgery , Skin Neoplasms/surgery , Carcinoma, Squamous Cell/surgery , Anus Neoplasms/complications , Skin Neoplasms/secondary , Carcinoma, Squamous Cell/secondary , Neoplasm Recurrence, LocalABSTRACT
Resumen El cáncer de cuello uterino ocupa el cuarto lugar dentro de las neoplasias de origen ginecológico a nivel global, representando un 85% de los casos en países en vías de desarrollo. Las metástasis cutáneas de origen ginecológico son altamente infrecuentes, observándose con mayor frecuencia en las neoplasias malignas de ovario, seguidas del adenocarcinoma endometrial y de cuello uterino y, menos frecuentemente, las de subtipo escamocelular. En la actualidad, existen alrededor de 80 reportes de casos citados en la literatura de metástasis cutáneas secundarias a un carcinoma de cuello uterino; sin embargo, ninguno con localización en la piel del cuello que se origine de un subtipo histológico escamocelular. En Colombia, no hay casos reportados hasta la fecha. Se presenta el caso de una paciente de 43 años que consulta por sangrado vaginal, dolor abdominal y una extensa placa tumoral exofítica de aspecto metastásico en la piel del cuello y del hombro izquierdo, encontrando al examen clínico inicial una masa tumoral en el cuello uterino con confirmación histológica de un carcinoma escamocelular como neoplasia primaria. Se hace diagnóstico de Carcinoma de cuello uterino estadio IVB y se inicia un tratamiento con intención paliativa con radioterapia y posterior quimioterapia sistémica. La enfermedad metastásica de origen ginecológico a nivel cutáneo confiere un mal pronóstico, con una supervivencia reportada de 1 a 37 meses después de su diagnóstico, por lo cual se deduce que la prevención y el diagnóstico temprano, particularmente en cáncer de cuello uterino, es de vital importancia en la población general.
Abstract Cervical cancer is the fourth most common cancer among gynecological neoplasms globally, representing 85% of cases in developing countries. Cutaneous metastases of gynecological origin are very rare, observed more frequently in ovarian malignancies, followed by endometrial and cervical adenocarcinoma and less frequently those of the squamous cell subtype. Currently there are about 80 case reports cited in the literature of cutaneous metastases secondary to cervical carcinoma, however, none with localization in the skin of the neck originated from a squamous cell histological subtype. In Colombia, there are no reported cases to date. We present the case of a 43-year-old patient who consulted for abdominal pain, vaginal bleeding and an extensive exophytic tumor plaque of metastatic appearance in the skin of the neck and left shoulder, finding a tumor mass in the cervix with histological confirmation of a squamous cell carcinoma as primary tumor. A diagnosis of stage IVB cervical carcinoma is made, and treatment is initiated with palliative intention with radiotherapy and subsequent systemic chemotherapy. Cutaneous metastatic disease of gynecological origin confers a poor prognosis, with a reported survival of 1 to 37 months after its diagnosis, for which prevention and early diagnosis, particularly in cervical cancer, is of vital importance in the general population.
Subject(s)
Humans , Female , Adult , Carcinoma, Squamous Cell , Uterine Cervical Neoplasms , Cervix Uteri , Adenocarcinoma , Neoplasm MetastasisABSTRACT
ABSTRACT: Endometrial carcinoma is a very rare cause of cutaneous metastasis.The most frequent presentations of cutaneous metastasis are fast developing nodules or tumors, which are evi-dence of widespread dissemination in such patients.We report a case of scalp metastasis from an endometrial adenocarcinoma with a fatal prognosis. (AU)
RESUMO: O carcinoma endometrial é uma causa rara de metástases cutâneas.A apresentação mais frequente de metástases cutâneas são nódulos ou tumores de rápido desenvolvimento, que evidenciam uma disseminação generalizada nesses pacientes.Relatamos um caso de metástase no couro cabeludo de um adenocarcinoma endometrial com prognóstico fatal. (AU)
Subject(s)
Humans , Aged , Prognosis , Scalp , Adenocarcinoma , Endometrial Neoplasms , Neoplasm MetastasisABSTRACT
Lung carcinoma is the most common carcinoma seen in males with the skin being a rare metastatic site. Adenosquamous carcinoma as a rare histologic subtype, showing cutaneous metastasis is an unusual event with no reports in the literature till date. Skin metastasis is an alarming sign, carries poor prognosis, and is associated with shortened survival. Herein, we report a case of 60-year-old male who presented with isolated cutaneous metastasis as a chronic nonhealing ulcer over the sternal region for 3 years (unusual) in the first place, without any other associated symptoms and clinical evidence of the primary. Wide local excision of the lesion was performed after proper workup which revealed metastatic adenosquamous carcinoma. The patient was advised systemic chemotherapy. A high index of suspicion along with clinico-radio-pathological correlation in these cases is of utmost importance and forms the basis of accurate diagnosis
ABSTRACT
Cancer en cuirasse in a case of primary adenocarcinoma rectum is an exceedingly rare phenomenon which is scarcely seen in isolated case reports only. It is a specific morphological variant of cutaneous metastasis characterised by diffuse induration and oedema of cutis which is studded with carcinomatous lesions. Cutaneous metastases often occur in elderly individuals in their sixth decade or later. Herein we present a case of carcinoma en cuirasse arising in a young female who was operated for adenocarcinoma rectum.
ABSTRACT
RESUMEN Las metástasis cutáneas (MC) constituyen una manifestación infrecuente de neoplasias internas. Su diagnóstico requiere un alto índice de sospecha clínica, pues los hallazgos pueden ser sutiles. Estas ponen de manifiesto la presencia de un tumor maligno diseminado y pueden permitir el diagnóstico de neoplasias internas no conocidas, o indicar la diseminación o recurrencia de otras ya diagnosticadas. La MC del carcinoma de ovario suele aparecer en enfermedad avanzada e indican un mal pronóstico.Su reconocimiento temprano puede llevar a un diagnóstico preciso y rápido, con el consiguiente tratamiento oportuno, aunque en la mayoría de los casos son indicativas de un pronóstico infausto.
SUMMARY Cutaneous metastases are an infrequent manifestation of internal neoplasms. Its diagnosis requires a high index of clinical suspicion, since the findings can be subtle. These reveal the presence of a disseminated malignant tumor and can allow the diagnosis of unknown internal neoplasms, or indicate the dissemination or recurrence of others already diagnosed. MC of ovarian carcinoma usually appears in advanced disease and may indicate a poor prognosis. Early recovery can carry out an accurate and rapid diagnosis, with timely emergency treatment, although in most cases they are indicators of an unfortunate prognosis.
Subject(s)
Humans , Female , Middle Aged , Ovarian Neoplasms/complications , Skin Neoplasms/diagnosis , Neoplasm Metastasis/diagnosis , Adenocarcinoma/complicationsABSTRACT
Cancer of the uterine cervix is one of the leading gynecological malignancies of developing nations including India. A 45-year-old female presented with menstrual irregularities and other nonspecific symptoms. After initial workup, she was diagnosed with carcinoma cervix, Stage IV A, while she was being planned to take up radical concomitant chemoradiotherapy, she developed widespread nodules over various sites over the body, which were histopathologically proven as metastatic lesions. She was treated with a palliative intent by radiotherapy and chemotherapy. Only a few such cases have been reported in the literature with variable outcomes. These rare presentations should be thoroughly worked up and studied to know more about their biological behavior.
ABSTRACT
Visceral malignancies often present as cutaneous lesion and are an important clue towards the diagnosis. Authors report a case of a 64 years old male, who presented to us with right hemiparesis and multiple purple-red skin lesions. Systematic evaluation, thorough history and histological examination of the skin lesion showing the characteristic lesion lead to a final diagnosis of Renal Cell Carcinoma. Although in the history and physical examination there was no sign of Renal Cell Carcinoma, but eventually the case turned out to be an extensively spread cancer. This kind of Cutaneous lesions in a case of RCC is a rare phenomenon and has not been frequently mentioned in the previous literature, thus this case reminds us about the importance of a detailed clinical look out in each and every patient and various clues to make a correct and timely diagnosis of systemic diseases. The list of visceral malignancies causing cutaneous metastasis is quite long and requires a battery of test to diagnose the same.
ABSTRACT
Cholangiocarcinoma accounts for less than 2% of all malignant neoplasms. Its cutaneous metastases are extremely rare, accounting for 0.0002% of all cases. The ventriculoperitoneal (VP) shunt has been considered a potential route for tumor dissemination. This type of tumor proliferation has been well documented in patients with intra-abdominal metastases secondary to brain tumors and, less frequently, brain metastases secondary to intra-abdominal tumors. In spite of that, there are few reports of cutaneous metastases along the VP shunt catheter trajectory. We present the case of a cholangiocarcinoma cutaneous metastasis at the VP shunt trajectory as the first clinical sign of this type of tumor. The patient had undergone the shunt insertion 4 years earlier due to a hydrocephaly secondary to a subarachnoid hemorrhage. After diagnosis, she was referred to chemotherapy and oncology follow-up. In the literature, 30 cases of cutaneous metastasis of cholangiocarcinoma were reported. Dissemination has been described involving percutaneous biliary drainage and distant sites. However, the case presented in this study alerts us about the possibility of cutaneous metastasis of intra-abdominal tumors in the trajectory of VP shunt catheters.
O colangiocarcinoma representa menos de 2% das neoplasias malignas. Sua metástase cutânea é extremamente rara, representando 0.0002% dos casos. A derivação ventrículo-peritoneal (DVP) tem sido considerada uma via potencial para a disseminação dos tumores. Essa propagação tumoral já foi bem descrita em pacientes com tumores do sistema nervoso central e metástases intra-abdominais e, menos frequentemente, em metástases cerebrais secundárias a tumores intra-abdominais. Apesar disso, a presença de metástases cutâneas ao longo da trajetória do cateter de DVP é pouco relatada. Apresentamos o caso de uma paciente portadora de DVP há quatro anos devido a uma hidrocefalia secundária à hemorragia subaracnoide e que apresentou metástases cutâneas de colangiocarcinoma na trajetória do cateter de derivação como o primeiro sinal clínico do tumor. Após o diagnóstico, ela foi encaminhada para quimioterapia e acompanhamento com oncologia. Na literatura, foram relatados 30 casos de metástases cutâneas de colangiocarcinoma. Em geral, a disseminação pode envolver locais distantes ou cateteres de drenagem biliar percutânea. No entanto, o caso descrito neste estudo nos alerta sobre a possibilidade de metástases cutâneas de tumores intra-abdominais na trajetória de cateteres de DVP.
Subject(s)
Humans , Female , Aged , Ventriculoperitoneal Shunt , Cholangiocarcinoma , Neoplasm MetastasisABSTRACT
Resumen Caso clínico: paciente de 73 años de edad, con diagnóstico de adenocarcinoma ductal infiltrante en la mama izquierda. Se trató con mastectomía total, linfadenectomía axilar y quimioterapia. Diez años después le aparecieron un linfedema en el brazo izquierdo y hombro congelado. El linfedema estaba muy indurado y eritematoso, con numerosas lesiones costrosas y sobreinfectadas. La biopsia cutánea mostró infiltración neoplásica debida al carcinoma mamario y reporte de aumento de Ca 15.3. En el escáner cérvico-tóraco-abdomino-pélvico se observó derrame pleural izquierdo masivo, con atelectasia pulmonar subyacente y múltiples erosiones óseas, compatible con afectación tumoral. Tras recibir quimioterapia paliativa disminuyó temporalmente la infiltración cutánea tumoral. Conclusión: el carcinoma mamario es uno de principales cánceres que afectan a la mujer. Sus metástasis cutáneas son del orden de 37% a 5 años. El carcinoma en coraza es una variedad excepcional (3%), de evolución lenta, sin daño sistémico. Las pacientes con cáncer de mama deben tener un seguimiento estrecho postmastectomía y ante la sospecha de metástasis cutánea, diagnosticarla oportunamente para ofrecerles la opción del tratamiento temprano.
Abstract Clinical case: patient of 73 years of age, with diagnosis of infiltrating ductal adenocarcinoma in the left breast in 2004; it was treated with total mastectomy, axillary lymphadenectomy and chemotherapy; 10 years later, she had induration and erythema in the mastectomy area, with some superficial necrotic lesions and cutaneous infiltration to the right breast. In the left arm: indurated lymphedema, with numerous crusted, superficial and superinfected lesions. The skin biopsy showed neoplastic infiltration due to mammary carcinoma and an increase in Ca 15.3. In the cervico-thoraco-abdominal-pelvic scan, massive left pleural effusion was observed, with underlying pulmonary atelectasis and multiple bone erosions, compatible with tumor involvement. After receiving palliative chemotherapy, the cutaneous infiltration of the tumor decreased temporarily. Conclusion: mammary carcinoma is one of the main cancers that affect women. Their cutaneous metastases are of the order of 37% at 5 years. Cutaneous carcinoma is an exceptional variety (3%), of slow evolution, without systemic damage. Patients with breast cancer should have a close postmastectomy follow-up and, in case of skin metastasis suspicion, diagnose it in a timely manner to offer them the option of early treatment.
ABSTRACT
No abstract available.
Subject(s)
Humans , Male , Male , Breast Neoplasms, Male , Neoplasm MetastasisABSTRACT
No abstract available.
Subject(s)
Adenocarcinoma , Neoplasm Metastasis , Pancreatic NeoplasmsABSTRACT
Se describe el caso clínico de una anciana de 85 años de edad, quien fue ingresada en el Servicio de Medicina Interna del Hospital Clinicoquirúrgico Docente "Dr. Joaquín Castillo Duany", de Santiago de Cuba por presentar dolor lumbar, disuria y hematuria, además de un tumor de 6 cm de diámetro en la pared abdominal, región suprapúbica, desde hacía 6 meses. Se efectuó biopsia de la lesión, cuyos resultados informaron carcinoma urotelial infiltrante de alto grado, por lo cual fue trasladada al Servicio de Urología donde se le realizarían los exámenes propios de la especialidad. El diagnóstico se confirmó mediante la cistoscopia y el análisis histopatológico. No se llevó a cabo el tratamiento por negativa de sus familiares.
The case report of an 85 years old woman is described who was admitted in the Internal Medicine Service of "Dr. Joaquín Castillo Duany" Teaching Clinical Surgical Hospital in Santiago de Cuba due to low back pain, dysuria and hematuria, besides a 6 cm diameter tumor in the abdominal wall, suprapubic region, for 6 months. The biopsy of the lesion was carried out which results revealed high degree infiltrative urothelial carcinoma, reason why she was transferred to the Urology Service where the exams characteristic of the specialty would be carried out. The diagnosis was confirmed by means of the cystoscopy and the histopathological analysis. The treatment was not carried out due to her relatives refusal.
Subject(s)
Urologic Neoplasms , Neoplasm Metastasis , AgedABSTRACT
Non-Hodgkin lymphoma is a common childhood T-cell and B-cell neoplasm that originates primarily from lymphoid tissue. Cutaneous involvement can be in the form of a primary extranodal lymphoma, or secondary to metastasis from a non-cutaneous location. The latter is uncommon, and isolated cutaneous involvement is rarely reported. We report a case of isolated secondary cutaneous involvement from nodal anaplastic large cell lymphoma (CD30 + and ALK +) in a 7-year-old boy who was on chemotherapy. This case is reported for its unusual clinical presentation as an acute febrile, generalized papulonodular eruption that mimicked deep fungal infection, with the absence of other foci of systemic metastasis.
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No abstract available.
Subject(s)
Neoplasm Metastasis , Pancreatic Neoplasms , Scalp , ThoraxABSTRACT
Prostate cancer is one of the most common cancers among men worldwide and in the USA. Most prostate cancer progression either locally invades to seminal vesicles or metastasizes distally to bone. Skin is not a common site of metastasis for the majority of malignancies including prostate cancer. This paper reports two extremely rare cases of prostate carcinoma metastatic to the skin: a 74-year-old man previously treated with radiation for prostate cancer with cutaneous metastases to the shoulder and a 68-year-old man with prostate adenocarcinoma and cutaneous metastases to the groin. Both patients were diagnosed with skin punch biopsy and later confirmed with immunohistochemical staining for PSA and prostate specific acid phosphatase, specific for prostatic carcinoma. Although unusual, development of multiple skin lesions in patients with prostate adenocarcinoma should raise the flags of cutaneous metastases.