Metastatic cutaneous and subcutaneous lesions: Analysis of cases diagnosed on fine needle aspiration cytology

Abstract

Background: Cutaneous and subcutaneous metastasis from an underlying primary, indicates a dismal outcome for patients. It is appropriate to use fine needle aspiration cytology as a minimally invasive method for diagnosis. This study emphasises the role of fine needle aspiration cytology in diagnosing metastatic skin nodules. Materials and methods:This was a retrospective study in which the record of all patients subjected to fine needle aspiration cytology from April 2008 -Nov 2010 in the Department of Pathology, Tribhuvan University Teaching Hospital, were reviewed. Of 5,927 patients, 19 cases diagnosed as metastatic skin lesions were included in the study. Results:Out of 19 patients with metastatic skin nodules, 9 patients had metastasis simultaneously with the primary and 8 cases were previously diagnosed. All metastases were from internal solid organ tumours with male to female ratio of 1.7:1. Lung carcinoma was the most common to metastasis in both sexes which included adenocarcinoma (5 cases) and squamous cell carcinoma (6 cases). Common sites for cutaneous/subcutaneous metastasis were the chest wall (9 cases) followed by abdomen (4 cases) and scalp (3 cases). Conclusion:Fine needle aspiration cytology can diagnose a variety of skin lesions which may be supportive in diagnosing a metastasis in cases with known primaries or it may offer a clue to underlying malignancy in unsuspected cases.

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

“…Chest and abdomen is the commonest site of cutaneous metastases reported in the literature followed by head and neck. [1]The most common malignancies to metastasize to skin are lung followed by GI , melanoma ,RCC and carcinoma of oral cavity in males. Breast followed by colon ,melanoma ,lung ,ovary and sarcoma are the common primary sites in females.…”

“…Breast followed by colon ,melanoma ,lung ,ovary and sarcoma are the common primary sites in females. [1,4]Adenocarcinoma from various organs is the commonest to metastasize to skin. [1,5]Age ranges between 2-76 years.…”

“…[1,5]Age ranges between 2-76 years. [1,8] Differential diagnoses includes primary adnexal tumors and primary squamous cell carcinoma of skin .Metastases is usually located in deeper dermis and subcutaneous tissue and overlying skin is free.…”

“…The incidence of cutaneous metastases ranges from 0.8-9% [1,2,3,4]Typically they are associated with an advanced stage of diaease and a poorer prognosis .…”

“…[1,2,5]It offers a clue to underlying malignancy in case of an occult primary [5] This study was done to evaluate the role of FNAC in the diagnoses of metastatic cutaneous and subcutaneous nodules in patients with known malignancy or as a primary manifestation of an unknown malignancy.…”