Medicine of the Future in America

Category Archives: Skin metastasis

Skin metastasis from an occult esophageal adenocarcinoma: DISCUSSION (Part 2)

Pathology Cutaneous metastases are most often rapidly progressing late events with a poor prognosis. Our patient, however, had metastatic carcinoma of the skin manifesting as a clinically benign, small, solitary nodule with no other symptoms. The follow-up computed tomography scan revealed thickening of the gastric wall in the cardia, and the patient had no epigastric pain, epigastric discomfort, dyspepsia or regurgitation, and no weight loss. Continue reading

Skin metastasis from an occult esophageal adenocarcinoma: DISCUSSION (Part 1)

Cutaneous metastases are the 12th most frequent site for all tumour types . Skin infiltration may be the first sign of carcinoma, or it may accompany other symptoms or be noted during follow-up .The incidence of skin metastasis is 1% to 2.7% . The scalp is a relatively common site of cutaneous metastasis . Brownstein and Helwig reported that the scalp was the site in 4% of all skin metastases. Metastases to the skin from various internal organs are uncommon . Continue reading

Skin metastasis from an occult esophageal adenocarcinoma: CASE PRESENTATION (Part 3)

Immunohistochemical findings Immunohistochemical findings
For the immunohistochemical studies, formalin-fixed and paraffin-embedded sections were stained using the standard avidin-biotin-peroxidase complex method. The following monoclonal antibodies were applied: AE1/AE3, 1:50 dilution, Dako A/S, Denmark; CK7 (QV-TL12/30), 1:50 dilution, Dako; CK20, 1:100 dilution, Dako; epithelial membrane antigen, 1:200 dilution, Dako; p53 (DO7), 1:100 dilution, Dako; and c-erbB-2, 1:80 dilution, (Dako). Continue reading

Skin metastasis from an occult esophageal adenocarcinoma: CASE PRESENTATION (Part 2)

Axial spiral computed tomography scan of the abdomen with contrast revealed thickening in the fundus of the stomach with extension to the cardia, with no peripheral lymphadenopathy. A biopsy of the distal esophagus revealed the characteristic histological features of adenocarcinoma (Figure 3), and an esophageal extension of a gastric carcinoma remained to be excluded. Continue reading

Skin metastasis from an occult esophageal adenocarcinoma: CASE PRESENTATION (Part 1)

A 62-year-old woman presented with a small, nonulcerated, round, well-demarcated, dome-shaped, soft, mobile, nontender, painless, nonpruritic and clinically localized skin nodule of 0.5 cm diameter and of one month duration, over her left cheek. She told that a month and subsequently a week before her admission, her left cheek was bitten accidentally by her two-year-old grandson. Continue reading

Skin metastasis from an occult esophageal adenocarcinoma

Skin metastasisCutaneous metastases are rare. Metastases to the skin from carcinoma of internal organs are uncommon , yet they may be the first sign of neoplastic disease . Skin involvement is the first sign of the cancer in 0.8% of these patients, and the underlying cancer is undiagnosed in 60% of cases . Skin metastasis indicates dissemination and rapid fatal termination of the tumour. Esophageal carcinoma has a very poor prognosis, with a five-year survival rate of 8% to 12%. It is usually diagnosed at an advanced stage, making cure unlikely. Cutaneous metastases of esophageal adenocarcinoma are exceedingly rare . We report here a unique case of a 62-year-old woman who presented with a small, solitary, clinically localized skin nodule on her face. She had no other symptoms. A biopsy of the lesion revealed a metastatic adenocarcinoma, and subsequent investigations detected the tumour in the esophagus, despite the absence of local symptoms. Continue reading

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