Clinicopathologic Correlation of Cutaneous Metastases

Sariya, Dinesh; Ruth, Karen; Adams-Mcdonnell, Rose; Cusack, Carrie Ann; Xu, Xiaowei; Elenitsas, Rosalie; Seykora, John T.; Pasha, Terri; Zhang, Paul; Baldassano, Marisa; Lessin, Stuart R.; Wu, Hong Gyun

doi:10.1001/archderm.143.5.613

Cited by 178 publications

(201 citation statements)

References 34 publications

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“…Many physicians consider skin alterations a frequent manifestation of internal disease, at the same time, neoplastic diseases rarely spread to the skin particularly from internal organs [6,[10][11][12]. In our study autopsies revealed only less than 1 % prevalence of skin metastasis among gastrointestinal, lung, hepatobiliary and urogentital tract cancers.…”

Section: Discussioncontrasting

confidence: 45%

Skin Metastasis of Internal Cancers: A Single Institution Experience

Kovács

Kenessey

Tı́már

2013

Pathol. Oncol. Res.

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Skin metastatization of internal cancers are rare and a few studies are available analyzing its clinicopathological features. The reported incidence of skin metastasis is influenced by two factors: the relative proportion of cancers covered by skin in the various cohorts and the large differences in the prevalences of various cancer types. Futhermore, the anatomical distribution of skin metastases of various cancer types is aslo not well known. Therefore we have collected a skin metastasis cohort of biopsy and authopsy cases (n=80) from the archive of our department and analysed its clinicopathologic features. The adjusted skin metastasis prevalence data of various inner cancers indicated that kidney-, lung-and colorectal cancers have a strong positive preference for skin metastatisation while pancreatic cancer has a negative one. We have provided evidences that lower gastrointestinal-and genitourinary cancers preferred infradiaphragmatic skin regions unlike upper gastrointestinal cancers while lung-and kidney cancers preferred supradiaphragmatic regions. We have also detected that ventral skin regional metastasis is slightly more prevalent irrespective of the cancer type. Our study provide the first statistical data for the variations in skin preference of metastatisation among various cancer types as well as for the significant variations in their regional distributions.

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Section: Discussioncontrasting

confidence: 45%

Skin Metastasis of Internal Cancers: A Single Institution Experience

Kovács

Kenessey

Tı́már

2013

Pathol. Oncol. Res.

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“…[3][4][5][6]10 In studies published by Ivan et al, 4,5 tumors with o25% p63 nuclear staining were considered negative. Thus, with this higher cutoff value, the authors reported a 100% specificity with the majority of the cutaneous metastases being negative for p63, although focal staining was reported in 5 of 14 (36%) cases.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9][10] Current markers purportedly of utility as diagnostic adjuncts include p63 and D2-40, both reportedly preferentially expressed in the primary sweat gland carcinomas. [3][4][5][6]9,10 However, the utility of these is somewhat conflicting, given that frequent expression of p63 has been shown in 11-22% of metastatic cutaneous adenocarcinomas and that positive staining with D2-40, although focal, may be seen in up to 5% of cutaneous metastases. 3,6,9,10 Others markers cited include calretinin, found to be positive in 64% of primary cutaneous neoplasms and negative in 72% of cutaneous metastases.…”

mentioning

confidence: 99%

“…[3][4][5][6]9,10 However, the utility of these is somewhat conflicting, given that frequent expression of p63 has been shown in 11-22% of metastatic cutaneous adenocarcinomas and that positive staining with D2-40, although focal, may be seen in up to 5% of cutaneous metastases. 3,6,9,10 Others markers cited include calretinin, found to be positive in 64% of primary cutaneous neoplasms and negative in 72% of cutaneous metastases. 10 Although Qureshi et al 3 suggested that CK5/6 may also be diagnostically useful, other studies have shown that CK5/6 expression can be observed in 9-15% of adenocarcinomas of various primary sites.…”

mentioning

confidence: 99%

“…3,6,9,10 Others markers cited include calretinin, found to be positive in 64% of primary cutaneous neoplasms and negative in 72% of cutaneous metastases. 10 Although Qureshi et al 3 suggested that CK5/6 may also be diagnostically useful, other studies have shown that CK5/6 expression can be observed in 9-15% of adenocarcinomas of various primary sites. 11,12 Although not completely specific, the differential expression of CK7 and CK20 may also be helpful particularly in delineating the site of origin of the primary carcinoma.…”

mentioning

confidence: 99%

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The diagnostic utility of immunohistochemistry in distinguishing primary skin adnexal carcinomas from metastatic adenocarcinoma to skin: an immunohistochemical reappraisal using cytokeratin 15, nestin, p63, D2-40, and calretinin

et al. 2010

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Often the distinction of primary adnexal carcinoma from metastatic adenocarcinoma to skin from breast, lung, and other sites can be a diagnostic dilemma. Current markers purportedly of utility as diagnostic adjuncts include p63 and D2-40; however, their expression has been demonstrated in 11-22% and 5% of metastatic cutaneous metastases, respectively. Both cytokeratin (CK) 15 and nestin have been reported as follicular stem cell markers. We performed CK15 and nestin, as well as previously reported stains (such as p63, D2-40, and calretinin) on 113 cases (59 primary adnexal carcinomas and 54 cutaneous metastases). Expressions of p63, CK15, nestin, D2-40, and calretinin were observed in 91, 40, 37, 44, and 14% of primary adnexal carcinoma, respectively, and in 8, 2, 8, 4, and 10% of cutaneous metastases, respectively. p63 appeared to be the most sensitive marker (with a sensitivity of 91%) in detecting primary adnexal carcinomas. CK15 appeared to be the most specific marker with a specificity of 98%. Using v 2 analysis, statistically significant P-values (o0.05) were observed for p63, CK15, nestin, and D2-40 in the distinction of primary adnexal carcinoma versus cutaneous metastases. In logistic regression and stepwise selection for predicting a primary adnexal carcinoma, statistical significance was observed for p63, CK15, and D2-40 (P-values: o0.001, 0.0275, and 0.0298, respectively) but not for nestin (P-value ¼ 0.4573). Our study indicates that diagnostic sensitivity and specificity are significantly improved using a selected panel of immunohistochemical markers, including p63, CK15, and D2-40. Positive staining with all three markers argues in favor of a primary cutaneous adnexal neoplasm.

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Primary Mucinous Carcinoma of the Eyelid

Papalas¹

2010

Arch Ophthalmol

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Clinicopathologic Correlation of Cutaneous Metastases

Cited by 178 publications

References 34 publications

Skin Metastasis of Internal Cancers: A Single Institution Experience

Skin Metastasis of Internal Cancers: A Single Institution Experience

The diagnostic utility of immunohistochemistry in distinguishing primary skin adnexal carcinomas from metastatic adenocarcinoma to skin: an immunohistochemical reappraisal using cytokeratin 15, nestin, p63, D2-40, and calretinin

Primary Mucinous Carcinoma of the Eyelid

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