Cutaneous metastasis of neuroendocrine carcinoma

Fluehler, Catharina; Quaranta, Laura; Meo, Nicola di; Ulessi, Bruno; Trevisan, Giusto

doi:10.4103/0019-5154.110890

Cited by 6 publications

(3 citation statements)

References 2 publications

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“…Here, we reported a case of a small-cell rectal NEC with a very uncommon, subcutaneous tissue metastatic site. Cutaneous metastases are more commonly present in breast, lung, colon, stomach, uterus and kidney neoplasia [57], while spread to the skin is infrequent in neuroendocrine carcinomas and need to be differentiated from primary neuroendocrine skin tumors, in particular from Merkel cell carcinoma [58–60]. A review conducted by Amorim et al in 2015 [11] found 31 cases of cutaneous metastases of NET.…”

Section: Discussionmentioning

confidence: 99%

Poorly differentiated neuroendocrine rectal carcinoma with uncommon immune-histochemical features and clinical presentation with a subcutaneous metastasis, treated with first line intensive triplet chemotherapy plus bevacizumab FIr-B/FOx regimen: an experience of multidisciplinary management in clinical practice

et al. 2019

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BackgroundNeuroendocrine tumors (NETs) are heterogeneous, widely distributed tumors arising from neuroendocrine cells. Gastrointestinal (GI)-NETs are the most common and NETs of the rectum represent 15, 2% of gastrointestinal malignancies. Poorly differentiated neuroendocrine carcinomas of the GI tract are uncommon. We report a rare case of poorly differentiated locally advanced rectal neuroendocrine carcinoma with nodal and a subcutaneous metastasis, with a cytoplasmic staining positive for Synaptophysin and Thyroid Transcription Factor-1.Case presentationA 72-year-old male presented to hospital, due to lumbar, abdominal, perineal pain, and severe constipation. A whole-body computed tomography scan showed a mass of the right lateral wall of the rectum, determining significant reduction of lumen caliber. It also showed a subcutaneous metastasis of the posterior abdominal wall. Patient underwent a multidisciplinary evaluation, diagnostic and therapeutic plan was shared and defined. The pathological examination of rectal biopsy and subcutaneous nodule revealed features consistent with small-cell poorly differentiated neuroendocrine carcinoma. First line medical treatment with triplet chemotherapy and bevacizumab, according to FIr-B/FOx intensive regimen, administered for the first time in this young elderly patient affected by metastatic rectal NEC was highly active and tolerable, as previously reported in metastatic colo-rectal carcinoma (MCRC). A consistent rapid improvement in clinical conditions were observed during treatment. After 6 cycles of treatment, CT scan and endoscopic evaluation showed clinical complete response of rectal mass and lymph nodes; patient underwent curative surgery confirming the pathologic complete response at PFS 9 months.Discussion and conclusionsThis case report of a locally advanced rectal NEC with an unusual subcutaneous metastasis deserves further investigation of triplet chemotherapy-based intensive regimens in metastatic GEP NEC.

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Section: Discussionmentioning

confidence: 99%

Poorly differentiated neuroendocrine rectal carcinoma with uncommon immune-histochemical features and clinical presentation with a subcutaneous metastasis, treated with first line intensive triplet chemotherapy plus bevacizumab FIr-B/FOx regimen: an experience of multidisciplinary management in clinical practice

et al. 2019

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“…[15]3 cases of soft tissue sarcomas that had metastases to skin ans subcutaneous tissue were identified in 3 females .The histological types were epitheloid sarcoma, leiomyosarcoma and rhabdomyosarcoma .Metastases occured to interscapular area and abdominal wall .The diagnosis was established by FNAC.2 cases of metastaic neuroendocrine carcinoma were seen in our series .One patient had primary in salivary gland and the other presented with metastases in sacral area.Patient on follow up was found to have neuroendocrine carcinoma prostrate .Cutaneous metastases from neuroendocrine carcinoma of visceral organ has already been reported .When a neuroendocrine carcinoma is found in the skin ,it is importantto distinguish Merkel cell carcinoma from cutaneous metastases of visceral origin.Positive staining for CK20 is strongly diagnostic. [17]The diagnosis was confirmed by a complete IHC study of both primary and secondary lesions. Cutaneous metastases of an extracutaneous NHL seems to be poor prognostic factor.…”

Section: Resultsmentioning

confidence: 95%

Evaluation of Metastatic Cutaneous Lesions on Fine Needle Aspiration Cytology: A Five Year Study

Yasin¹,

Bashir²,

Khan³

2017

AABS

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Background: Cutaneous and subcutaneous metastatic deposits are rare and can be seen in 0.8-5% cases. This study was done to evaluate the role of Fine Needle Aspiration Cytology(FNAC) in the diagnosis of cutaneous and subcutaneous nodules in patients with known malignancy or as a primary manifestation of an unknown malignancy. Methods:It was a 5 year retrospective study and the record of patients subjected to FNAC during this period was reviewed.Results: Out of total number of 13572 patients 58(0.42%) were diagnosed as cutaneous /subcutaneous metastatic deposits .In 51 cases ,the primary was known and in 7 cases it was an initial manifestation of an unknown primary. There were 39 males and 19 females with age range of 27-82 years .Conclusion: Commonest site of metastases was chest wall and most common primary was lung. Adenocarcinoma was the commonest diagnosis on morphology. This study emphasizes the efficacy of FNAC on the accurate diagnosis of subcutaneous nodules especially in patients with known malignancy .It also offers clue to the underlying malignancy in occult primary.

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“…The location was most frequently on the cephalic segment (typically on the scalp) and/or trunk. We call attention to two distinct cases: (1) painful spots referred by the patient without visible or palpable cutaneous lesions; (2) single hardened lesion on the eyelid, simulating the primary cutaneous lesion [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%