Multiple Cutaneous Metastases as Initial Presentation in Advanced Colon Cancer

Abstract

Skin metastases from advanced colorectal cancer are relatively rare and occur most often when the cancer is advanced, following the spread to other organs. Cutaneous metastases occur in about 3% of advanced colorectal cancers. We present an extremely rare case of a 68-year-old woman with advanced ascending colon adenocarcinoma that presented with multiple rapidly progressing painless cutaneous metastatic lesions with no other distant metastases. Of all the tumors, breast cancer most commonly spreads as cutaneous metastasis is followed by lung, colorectal, renal, ovarian, and bladder cancers. Cutaneous metastases can present in a variety of clinical manifestations, such as a rapidly growing painless dermal or subcutaneous nodule with intact overlying epidermis or as ulcers. In cases where the cutaneous deposit is isolated, as in visceral metastasis, there is a role for radical management such as wide local excision and reconstruction. In our patient, since she had multiple cutaneous metastases she began treatment with palliative systemic combination chemotherapy.

Cutaneous Metastasis from Colorectal Cancer: Making Light on an Unusual and Misdiagnosed Event

“…Cutaneous cancer metastases are a rare event, occurring in about 1.3% of cases at the time of presentation of the primary tumor [ 4 ]. The insurgence of cutaneous metastasis is infrequently described as the first sign of malignancy in CRC and occurs with greater frequency in breast and lung carcinoma, followed by kidney and ovarian cancer [ 1 , 5 , 9 , 10 ].…”

“…The most frequent cutaneous site of CRC metastasis is the surgical scar in the abdomen resulting from the removal of the primary malignancy, followed by the extremities, perineum, head, neck, and penis. An atypical localization is the umbilical region also knows as ‘Sister Mary Joseph nodule’ [ 4 ]. Metastases to the thigh and back of the trunk are anecdotical [ 4 , 5 ].…”

“…An atypical localization is the umbilical region also knows as ‘Sister Mary Joseph nodule’ [ 4 ]. Metastases to the thigh and back of the trunk are anecdotical [ 4 , 5 ].…”

Cutaneous Metastasis in the Setting of Both Colon and Breast Primary Malignancies

“…More often, cases of breast cancer followed by lung, colorectal, renal, ovarian, and bladder cancers involve discussions of cutaneous metastases. These present heterogeneously as slow-growing tumors to rapidly growing dermal or subcutaneous nodules with either intact or ulcerated epidermis [ 13 ]. We present a unique case of a patient with a past medical history of basal and squamous cell carcinoma who presented with what was ultimately found to be cutaneous metastases from a colon primary without hepatic involvement in the context of a new synchronous diagnosis of an invasive ductal carcinoma of the breast.…”

Cutaneous and breast metastasis from colorectal adenocarcinoma: A rare case report

“…A survey reported that secondary neoplasms of the breast account for 0.43% of all breast malignancies (1), and the colorectum as the primary site is even rarer. Cutaneous metastasis from colorectal cancer is also a rare (3%) event (2). The majority of cutaneous or breast metastases indicate widely disseminated disease and are associated with poor clinical outcome.…”