Dermal Metastasis from Nasopharyngeal Carcinoma: A Rare Form of Metastasis

Abstract

Objective: To report a rare form of metastasis from a primary nasopharyngeal carcinoma, a
 creeping form of dermal metastasis.
 
 Methods:
 Design: Case Report
 Setting: Tertiary Public University Hospital
 Patient: One
 
 Results: A 47-year-old male referred for radiotherapy after having undergone a selective neck dissection for multiple cervical lymphadenopathy with histopathologic diagnosis of undifferentiated carcinoma and no known primary underwent a four-quadrant nasopharyngeal biopsy which confirmed the presence of nasopharyngeal carcinoma. Subsequent radiotherapy resolved the primary mass , and a new posterior cervical lymph node that appeared five months after completion of radiotherapy also resolved with additional radiotherapy. He was asymptomatic for two years until he noted thickening of the skin in his left supraclavicular area. A Computed Tomography (CT) scan showed deep cervical adenopathy and skin thickening, and biopsy confirmed dermal metastatic carcinoma. Two courses of radiotherapy to the affected skin and left axilla where a lymph node had developed resulted in resolution and he was referred for chemotherapy.
 
 Conclusion: Dermal metastasis from nasopharyngeal carcinoma is rare and does not present with pathognomonic symptomatology. It may therefore be confused for a benign side effect (dermatitis), not the malignant manifestation that forebodes a bad prognosis. Patients with dermal metastasis should receive treatment, and radiotherapy may play a significant part. Chemotherapy may also play a role in its management.
 
 Keywords: Nasopharyngeal carcinoma, dermal metastasis