Cutaneous Metastatic Adenocarcinoma of the Colon to the Scalp

Abstract

Cutaneous metastases from colorectal cancer are relatively uncommon presenting in fewer than 5% of patients but they are very important to recognize as they signify disseminated disease and poor prognosis. We describe a case a 62-year-old patient diagnosed with scalp metastasis during his systemic chemotherapy treatment for a colorectal carcinoma stage IVb who underwent excisional biopsy of the metastatic lesion. The identification of cutaneous metastases from colorectal cancer can radically alter therapeutic plans as they typically indicate a wide spread disease. Although they can be observed at any stage of malignancy, early recognition can lead to accurate and prompt diagnosis and timely treatment.

Alopecia neoplastica as a sign of visceral malignancies: a systematic review

“…Women were more represented with the 53.7% (66/123) of cases, compared to the 46.3% (57/123) of men . Median age of AN at onset was 59 (IQR: 47–68).…”

“…Regarding the primary site of malignancy, gastrointestinal (GI) tract accounted for 24.4% (30/123), breast for 17.9% (22/123) of cases, kidney for 8.1% (10/123), lung for 7.3% (9/123), thyroid for 7.3% (9/123), uterus for 6.5% (8/123), central nervous system (CNS) for 6.5% (8/123), liver for 3.3% (4/123) and other anatomic areas for 18.7% (23/123) of cases …”

“…Regarding the primary site of malignancy, gastrointestinal (GI) tract accounted for 24.4% (30/123), 2,14,16,23,30,32,33,36,46,48,49,56,61,63,64,71,78,79,83,84,88,93,96,98,101,102,105,106,115,118 breast for 17.9% (22/123) of cases, 4,6,7,10,11,13,15,[17][18][19]26,27,29,34,35,37,44,66,67 kidney for 8.1% (10/123), lung for 7.3% (9/ 123), 25,38,43,<...>…”

“…Regarding clinical appearance, AN was identified as a nodule, plaque and patch in 58% (69/119), 8,9,21,22,24,27,33,34,37-41,43,44,46,47,49- 2,6,7,11,[14][15][16][17][18][19][20]23,25,29,67,96 respectively; under the general term of a 'mass' in 16.8% (20/119) 28,32,35,42,45,48,58,59,71,73,80,81,83,87,95,106,110,111,114,117 and as an 'excoriated lesion' in 2.5% (3/119) of cases. 69,78,109 Specifically, breast cancer was mainly associated with patch lesions (9/20), followed by plaques and nodules (five and five out of 20, respectively).…”

A rare case of carcinoma rectum with scalp metastasis: an unusual presentation

“…Skin involvement of rectal cancers usually appear as subcutaneous or intradermal small nodules, dark brown or violet in color and they can be confused with sebaceous cyst, lipomas or neurofibromas due to their characteristics. [5][6][7] Choroidal metastasis from colon cancer has only been reported in 14 cases in the literature, and the frequency of skin metastasis in colorectal carcinoma has been reported in only 2.3%-6% of cases. 8 However, in our patient the appearance was a solitary exophytic nodular swelling with overlying skin showing erythema, ulceration, crusting and focal loss of hair which was firm in consistency.…”