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Carcinoma of the uterine cervix is the most common gynecological malignancy in developing countries. However, its cutaneous metastasis is a rare entity. The reported incidence of cutaneous metastasis ranges from 0.1 to 2%. Frequent sites of cutaneous metastasis in decreasing order are: abdominal wall, vulva and anterior chest wall. To the best of our knowledge, only three cases of cutaneous metastasis to the upper extremity have been reported in the world. We report a case of a 74-year-old postmenopausal lady diagnosed to have carcinoma cervix (stage IIIB) who presented with cutaneous metastasis to palm and thigh, 10 months after radical radiotherapy. At presentation, the primary disease had resolved completely. She had a small nodular growth in the left palm and left thigh. Fine needle aspirate cytology and core needle biopsy from both the nodular lesions were positive for squamous cell carcinoma.

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ABSTRACT

Background: Lipodystrophy (LD) is potentially stigmatizing and contributes to poor adherence to antiretroviral therapy. Objectives: To find out the prevalence and pattern of LD among Acquired Immune Deficiency Syndrome (AIDS) patients receiving Highly Active Antiretroviral Therapy (HAART), and to assess the psychological distress related to LD. Materials and methods: A cross-sectional study was designed after institutional ethical clearance and informed consent from 50 AIDS patients on HAART. Data collected were physical examination and response to a standardized questionnaire (Assessment of Body Changes and Distress questionnaire). They were analyzed using SPSS 14.0. Results: All subjects were on lamivudine, stavudine, and nevirapine (82%) or efavirenz (18%). The prevalence of LD was 28% (M = 5; F = 9) and significantly more among women (P = 0.019). The pattern of LD perceived by patients and assessed on physical examination were abdominal obesity in 50 and 38%, breast hypertrophy in 28 and 14%, wasting of buttocks in 22 and 26%, lipoatrophy of arms in 24 and 28%, and wasting of facial muscles in 20 and 32%, respectively. The overall perceived changes were 68%, while assessed were 62%. The body changes caused significant psychological distress to the patients (P = 0.001), although compliance was good. Conclusion: The study calls for early detection of LD and treatment or provision of alternative medicines and counseling of these patients, to reduce the physical and psychological burden.