Multiple Cutaneous Metastases Research Articles

Skin Tumors Revealing Highly Metastatic Squamous Cell Lung Cancer

Lung cancer stands as a leading cause of cancer-related mortality globally, with its late-stage diagnosis presenting significant challenges. This case report delves into the case of a 57-year-old chronic smoker diagnosed with advanced non-small cell lung cancer (NSCLC) characterized by multiple cutaneous metastases, a rare manifestation. Despite the rarity, these skin lesions offer a valuable diagnostic avenue, albeit often indicating a grim prognosis, especially when coupled with other distant metastases and inoperable primary tumors. Through an exploration of the presented case, we underscore the importance of astute physical examination and heightened clinical awareness in detecting these elusive lesions. By enhancing early detection strategies and understanding the molecular underpinnings of metastatic spread, we aspire to improve diagnostic accuracy, treatment efficacy, and ultimately, the overall outcomes for patients facing this challenging condition.

Cutaneous metastases of internal malignancies: a single-institution experience.

AimsCutaneous metastases of internal malignancies occur in 1–10% of cancer patients. The diagnosis can sometimes be challenging, especially in cases with an unknown primary cancer.Materials and methodsA retrospective case review was performed including all cases of skin metastases from primary internal malignancies diagnosed at the Department of Pathology at the Maastricht University Medical Centre+ from 2007 to 2021. The clinicopathological data were collected and immunohistochemical and molecular diagnostic tests were performed to confirm the primary origin of the metastases.ResultsWe identified 152 cases (71 female; 31 male patients) of cutaneous metastases of internal malignancies. 28 patients (20 women and 8 men) were diagnosed with multiple cutaneous metastases. Among the female patients, the most common primary tumour was breast cancer (50% of the cases), followed by lung (13.6%), gynaecological (7.3%), and gastrointestinal origin (7.3%). Among the male patients, the most common primary sites were gastrointestinal and lung origin (altogether, 50% of the cases). In 19 patients, the cutaneous metastasis was the first presentation of a clinically silent internal malignancy (18.6%), of which most (78.9%) represented metastatic lung carcinomas. Finally, metastasizing patterns were different across tumour types and gender.ConclusionBreast, lung, gastrointestinal, and gynaecologic cancers are the most common primary tumours demonstrating skin metastases. Infrequently, cutaneous metastases can be the first clinically visual manifestation of an underlying not yet diagnosed internal malignancy; therefore, occasional broad immunohistochemical profiling, molecular clonal analysis, and a continuous high level of awareness are necessary for a precise diagnosis of cutaneous metastases of internal malignancies.

Sarcomatoid renal cancer with multiple cutaneous metastases

Clinical case description: A 47-year-old man presented with violet-red nodular cutaneous lesions on the face, scalp, and hands. Biopsy report stated metastatic kidney tumor. Physical examination revealed fair general status and a palpable abdominal mass. Urinalysis showed microhematuria. Tomography identified a right kidney tumor infiltrating the perirenal fat. Right radical nephrectomy was performed, and the histopathologic study described a clear cell renal cell tumor, with a 60% sarcomatoid component. Sunitinib was begun, resulting in cutaneous lesion involution. During two weeks of intermittent therapy, the lesions reappeared, and the dose was modified. Three months later, the patient presented with brain, liver, and bone metastases. After showing no improvement, the patient died five months after diagnosis. 
 Relevance: Not only was our case one of a rare form of metastatic kidney cancer that recurred despite treatment with tyrosine kinase therapy, the tumor also had sarcomatoid differentiation, a very aggressive variant of kidney cancer.
 Clinical implications: Cutaneous metastases from kidney cancer have an incidence of approximately 3%. Even though their prognosis is not good, opportune detection is essential for the patient.
 Conclusions: Sarcomatoid renal cancer is a rare tumor with a poor prognosis and is generally associated with distant metastasis. Every patient diagnosed with kidney cancer should undergo a comprehensive skin assessment, for adequate staging and treatment.

Multiple Cutaneous Metastasis of Follicular Thyroid Carcinoma in the Scalp and Upper Extremities

Multiple Cutaneous Metastasis of Follicular Thyroid Carcinoma in the Scalp and Upper Extremities

Multiple cutaneous metastasis of synchronous urothelial carcinoma of the bladder and the renal pelvis: a case report

IntroductionCutaneous metastatic disease arising from urinary tract carcinoma is rare and associated with a poor prognosis. We report a case of metastatic disease occurring in a patient treated for synchronous urothelial tumor of the bladder and left renal pelvis.Case presentationA 61-year-old Caucasian man was treated for a synchronous urothelial tumor of the bladder and left renal pelvis. He had an en bloc radical cystectomy and left ureteronehprectomy associated with a cutaneous transileal urinary diversion and lymph node dissection. He was scheduled for chemotherapy but was lost to follow-up. He consulted 1 year later with growing skin tumors that were confirmed to be metastatic disease, and he was referred to the oncology department for palliative chemotherapy.ConclusionCutaneous metastatic disease is a rare entity with poor prognosis. The main treatment remains chemotherapy; however, single-site metastasis should be considered for metastasectomy.

Multiple Cutaneous Metastasis of Rectal Cancer

Multiple Cutaneous Metastasis of Rectal Cancer

Multiple cutaneous in-transit metastasis from cutaneous melanoma

Multiple cutaneous in-transit metastasis from cutaneous melanoma

Multiple cutaneous metastasis of sacral chordoma, mimicking neurofibromas clinically

Chordoma is a rare primary bone tumor of notochordal origin, constituting 1-4% of malignant primary bone tumors. Chordomas are slow growing tumors and show aggressive local extension, multiple recurrences and metastasis. Cutaneous metastasis of chordoma is very rare. We report a case of a 61-year-old man presenting with multiple cutaneous metastasis of primary sacral chordoma.DOI:10.21276/APALM.1753

Laser-Assisted Delivery Of Cold Atmospheric Plasma In Unresectable Cutaneous Metastasis In Melanoma Patients

According to the World Health Organization, the incidence of melanoma is increasing faster than that of any other major cancer in the world. Melanoma is the fifth most common cancer in the United States, posing a substantial health and economic burden. Treatment of early and multiple cutaneous unresectable metastasis in melanoma patients is a major therapeutic problem. Cold atmospheric plasma (CAP) contains electrons, charged particles, radicals, various excited molecules, UV photons, and transient electric fields. These various compositional elements have the potential either to enhance cellular activity, or to disrupt it. In particular, based on this unique composition, CAP could offer a minimally-invasive surgical approach allowing for specific cancer cell or tumor tissue removal without influencing healthy cells. Topical application of treatment agents is a basic principle of dermatological therapy. However, the effective barrier function of the skin significantly impairs the bioavailability of most topical drugs. Fractional ablative lasers represent an innovative strategy to overcome the epidermal barrier in a standardized, contact-free manner. The bioavailability of topical agents can be significantly enhanced using laser-assisted delivery. Ablative fractional laser resurfacing creates vertical channels that might assist the delivery of topically applied cold plasma into cutaneous melanoma metastasis. For lesions refractory to elective treatments, the laser-assisted drug delivery technique combined with cold atmospheric plasma may present a new potential option. We report on a pilot study showing a proof of concept for enhancing topical cold atmospheric plasma permeation into depth by ablative fractional laser technique.

Unusual long-lasting cutaneous complete response to lapatinib and capecitabine in a heavily pretreated HER2-positive plurimetastatic breast cancer patient.

Lapatinib, in combination with capecitabine, has shown clinical activity in both first-line and refractory disease in patients with HER2-positive advanced breast cancer. Herein we describe the case of a plurimetastatic, heavily pretreated, HER2-positive breast cancer patient who experienced multiple cutaneous metastases successfully treated with lapatinib and capecitabine. An early complete response was obtained on all skin lesions, and no evidence of disease progression at other metastatic sites was observed for 22 months. The treatment was well tolerated, without dose-reductions or delays. In advanced breast cancer patients with skin metastases overexpressing HER2, previously treated with anthracyclines, taxanes and trastuzumab, lapatinib and capecitabine may represent a very active, safe and well-tolerated treatment option.

Cutaneous metastases from colon carcinoma-An unusual presentation.

Background: Cutaneous metastases from colorectal cancer is a rare event. It indicates widely spread disease with poor prognosis. Case Report: A 40 years old male, diagnosed case of adenocarcinoma of the ascending colon, presented with multiple cutaneous nodules over the trunk, back and the legs. Histopathological examination of one of the cutaneous nodule showed deposits of signet ring cell carcinoma. Conclusion: Multiple cutaneous metastasis from signet ring cell carcinoma is uncommon. This entity should be recognized in patients of colonic primary as it depicts wide spread disease with poor prognosis.

A Case of Multiple Cutaneous Metastases from Hepatocellular Carcinoma Mimicking Pyogenic Granuloma

Hepatocellular carcinoma (HCC) metastasizing to the skin is uncommon and carries a poor prognosis. The most frequent sites of skin metastasis are the face and scalp. Cutaneous metastatic lesions usually appear as nodules, but sometimes show a pyogenic granuloma-like morphology. We report a case of multiple skin metastases from HCC that resembled pyogenic granulomas, and showing HepPar1 as a specific marker of HCC. A key feature in this case was metastasis to the mandibular gingiva and digits. This case emphasizes the need to recognize that gingival and digital masses like benign or inflammatory lesions might represent an initial sign of HCC.

Metástasis cutáneas múltiples en tránsito de melanoma cutáneo

Metástasis cutáneas múltiples en tránsito de melanoma cutáneo

Carcinoma Buccal Mucosa with Multiple Cutaneous Metastases

Carcinoma Buccal Mucosa with Multiple Cutaneous Metastases

Multiple cutaneous metastases from squamous cell carcinoma base of tongue: A very rare case report

Multiple cutaneous metastases from squamous cell carcinoma base of tongue: A very rare case report

Multiple Cutaneous Metastasis of a Malignant Leydig Cell Tumour in a Dog

A testicular Leydig cell tumour associated with metastatic disease is reported in a dog. An enlarged testis and three cutaneous nodules resected from an 11-year-old golden retriever were submitted for histopathological examination. Both testicular and cutaneous lesions showed identical morphological and cytological changes. Immunohistochemical labelling for expression of inhibin-α and calretinin confirmed the Leydig origin of the cutaneous neoplastic population. Based on the morphological and immunohistochemical findings, a final diagnosis of multiple cutaneous metastasis of a malignant testicular Leydig cell tumour was made.

Cutaneous and Subcutaneous Soft Tissue Tumours in Snakes: A Retrospective Study of 33 Cases

Cutaneous and subcutaneous soft tissue tumours have been rarely described in detail in snakes. Several malignant entities show strikingly similar histological patterns and therefore the term soft tissue sarcoma (STS) has become a standard histopathological diagnosis. The present study characterizes soft tissue tumours in 33 snakes. Samples included 29 surgically excised masses and four carcasses. Additionally, six animals were humanely destroyed and submitted for necropsy examination following tumour recurrence. Benign neoplasms (n=8) were described as lipomas of varying differentiation. Recurrence was observed in two of five snakes in which the clinical course was recorded. Malignant neoplasms (n=25) were diagnosed as STS and graded according to a three-point system previously applied to canine STS. Five (20%) of the primary tumours were classified as grade 1, eleven (44%) as grade 2 and nine (36%) as grade 3 sarcomas. Clinically, recurrence of STS was observed in 11 of 17 cases with available follow-up information. Pathologically, multiple cutaneous metastases were found in one grass snake (Natrix natrix), while visceral metastases were observed in one carpet python (Morelia spilota) and two corn snakes (Pantherophis guttatus). Metastatic risk appears to increase with histological grade. Surgical excision generally represents the current therapy of choice for STS. This study includes the first reports of conventional lipomas in a ribbon snake (Thamnophis radix), angiolipomas in a black-headed python (Aspidites melanocephalus) and a corn snake as well as of STS in a Jamaican boa (Epicrates subflavus), emerald tree boa (Corallus caninus), grass snake (N. natrix), African house snake (Lamprophis fuliginosus), California kingsnake (Lampropeltis getula californiae) and common garter snake (Thamnophis sirtalis).

Multiple cutaneous metastasis of renal cell carcinoma: A rare presentation

Apart from breast carcinoma, malignancies rarely spread to the skin. Although renal cell carcinoma (RCC) has a high metastatic potential, metastasis to the skin is extremely rare. We present a case of a 50-year-old male with multiple nodular cutaneous metastases. Four months postnephrectomy, he was diagnosed cytologically and confirmed histopathologically. Such patients must be subjected to long-term clinical observation. Clinicians should pay attention to cutaneous lesions appearing in the patients with known case of internal malignancies. Prompt diagnosis and treatment will have its bearing on the eventual outcome.

Multiple Subcutaneous Nodular Metastasis from Transitional Cell Carcinoma of the Urinary Bladder in a Dog

A 10-year-old spayed female Pomeranian dog weighing 3.65 kg was presented with a 7-month history of urinary incontinence, stranguria and hematuria. The patient had mass lesions at left prescapular region (3 cm × 3 cm) and left axillary region (5 cm × 4 cm). Diagnosis of transitional cell carcinoma (TCC) with multiple cutaneous metastasis was made. Dog was treated with chemotherapy using mitoxantrone and piroxicam for 5 months. Although TCC size of urinary bladder was decreased during chemotherapy, there was no change of subcutaneous tumor size and mild relief of clinical signs. Partial anorexia for 3 weeks and multiple masses were noted at left caudal abdominal wall and left medial thigh (203 days after first presentation) and assessed as chronic kidney disease and additional subcutaneous metastasis of urinary bladder TCC by post-mortem and histopathological findings.

Adenocarcinoma lung presenting as multiple cutaneous metastasis: A rare initial presentation of lung carcinoma

Adenocarcinoma lung presenting as multiple cutaneous metastasis: A rare initial presentation of lung carcinoma