Medicine of the Future in America

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.Although carcinoma of the internal organs presents uncommonly with skin metastases, it is necessary that any nonhealing ulcers, persistent indurated erythemas and skin nodules of undetermined causes be biopsied to detect cutaneous metastasis of visceral cancer. It should be noted that the growth pattern of skin metastases may be unpredictable and may not reflect that of the primary tumour . Here we report a rare case of cutaneous metastasis before the detection of the primary site. The patient was considered to be at early stages of esophageal carcinoma. We present the histopathological features, and the immunohistochemical profile of both the primary and the metastatic tumours to assess the usefulness of these markers in deciding therapy. To our knowledge, similar cases have not been reported to date. Get most advantageous deals ever – zoloft for depression waiting for you round the clock.

This entry was posted in Skin metastasis and tagged Cutaneous metastases, Esophageal adenocarcinoma, Histology, Oncology, Pathology.
Copyright © 2012 Medicine of the Future in America www.perfexis.org