Medicine of the Future in America

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. Although the skin lesion was initially considered to be just a reaction to the bites, or a benign fibroma or a subcutaneous cyst, biopsy detected an adenocarcinoma suspicious for metastasis (Figure 1). On follow-up, the patient looked healthy; she had a good appetite and no major complaints. She was a nonsmoker, did not consume alcohol and was not addicted to drugs. Her body weight was within normal range and there was no history of any medication that may have affected her health. Physical examination was unremarkable. Her blood tests were all within normal limits, except for mild anemia. To detect the primary site of the cancer, radiography and endoscopy were used to evaluate the digestive system. She had no history of nausea, vomiting, increased or decreased sialorrhea, difficulty in swallowing, dyspepsia, reflux or heartburn, epigastric pain or discomfort, hematemesis or changes in bowel habits. A barium swallow demonstrated a slight mucosal irregularity in the distal esophagus extending to the esophagogastric junction, suggestive of a gastric or esophageal primary tumour (Figure 2).  Figure_1Figure 1) Whole-mount view of skin with metastatic adenocarcinoma. Hematoxylin and eosin staining, original magnification x40Figure_2Figure 2) A barium swallow showing deformity of distal esophageal mucosa Find most trusted pharmacy to discover cialis professional and enjoy your advantageous shopping.

This entry was posted in Skin metastasis and tagged Cutaneous metastases, Esophageal adenocarcinoma, Histology, Oncology, Pathology.
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