Early cutaneous metastasis from colonic adenocarcinoma

Abstract

CASE REPORT A 74­year­old female presented acutely to the surgical department with two rapidly growing, painful skin lumps. Her medical history included an emergency right hemicolectomy for perforated transverse colon secondary to a Dukes’ C1 T4 N1 M0 poorly differentiated colonic adenocarcinoma one month previously. Physical examination revealed a tender 3 cm cervical nodule (Figure 1) and a 2 cm nodule in left iliac fossa at the previous drain site (Figure 2). Laboratory testing revealed a mild normocytic anaemia (hemoglobin 10.4 g/L) and acutely deranged liver function tests. Computed tomograpy scan of the neck, chest, abdomen and pelvis confirmed a 3x3 cm necrotic left supraclavicular lymph node, 2.8x1.9 cm abdominal wall nodule in the left iliac fossa, and mild ascites. Fine needle aspiration cytology established a diagnosis of poorly differentiated metastatic adenocarcinoma. This patient was not a candidate for chemotherapy and she was treated with palliative care. DISCUSSION Cutaneous metastasis from colonic cancer is rare with an incidence of around 4% [1] and only a few cases have been reported [2–4]. Cutaneous metastasis may present at a variety of sites such as the abdominal wall, CLINICAL IMAGES OPEN ACCESS