Subcutaneous Nodules on the Face: Acantholytic In-Transit Cutaneous Metastasis

Abstract

Although skin is the biggest organ of the body, cutaneous or subcutaneous metastasis from internal malignancies or primary skin cancers is very uncommon. In this report, we present two cases of in-transit cutaneous metastasis in acantholytic pattern from a skin tumor on the face. Both patients presented with the subcutaneous nodule and had history of multiple squamous cell carcinomas on the face. The epidermis was intact above the nodule. Computed tomography scan was performed, and subcutaneous located cystic lesions were seen. Nodules were excised and reported as acantholytic squamous cell carcinoma. There was no recurrence or distant metastasis. There were no early or late complications. These nodules were in-transit metastasis of the previous multiple squamous cell carcinomas of the face. Although patients with squamous cell carcinomas presenting as subcutaneous nodules of the head were presented in the literature, to our knowledge, this is the first report to present in-transit metastasis of acantholytic squamous cell carcinoma.