Skin metastases from lung cancer: a case report

Pajaziti, Laura; Hapciu, Syzana; Dobruna, Shkendije; Hoxha, Naim; Kurshumliu, Fisnik; Pajaziti, Artina

doi:10.1186/s13104-015-1105-0

Cited by 27 publications

(33 citation statements)

References 22 publications

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“…Cases of skin (cutaneous/subcutaneous) metastases derived from neuroendocrine tumors of the lung [3][4][5][6][7][8], gastrointestinal [2,[9][10][11] and genitourinary tract [12][13][14][15] as well as of other origins or with unknown primary tumor site [16][17][18] have been exceptionally reported. In line with observations and revisions by Amorim et Al.…”

Section: Discussionmentioning

confidence: 99%

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Ciliberti¹,

Carbonara

Grillo³

et al. 2020

BMC Cancer

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Background: Skin metastases from pancreatic neuroendocrine carcinoma (PNEC) are rare and their palliative treatment is challenging. We report our experience in the multimodal management of one of the few reported cases of metastatic PNEC with multiple visceral and subcutaneous secondary lesions, focusing on the effectiveness of palliative radiotherapy for skin metastases. Case presentation: A 61-years old woman affected by a metastatic PNECwith subcutaneous growing and bleeding secondary lesions (at the scalp, right scapular region and at the back of the left thoracic wall, respectively) obtained a successful control of visceral metastases with the use of chemotherapy and an unexpected local response of her skin metastases with palliative radiotherapy. In particular, two subsequent radiation treatments were performed using different fractionation schedules (30 Gy in 10 fractions and 20 Gy in 5 fractions, respectively). Both radiation treatments were well-tolerated and patient's quality of life was improved. Local response was maintained until patient's deaththat occurred due to cachexia. Conclusions: The presented case highlights the effectiveness and the good tolerance of radiotherapy in the treatment of subcutaneous metastases; nevertheless, further knowledge of the optimal local palliative approach for PNEC metastatic sites is necessary. The experience gained in this work is the occasion to encourage a routine integrated multidisciplinary team management of metastatic PNECs because of their clinical complexity. The aim is to guarantee the optimization of the care with personalized and more effective systemic and local treatmentsalso including supportive cares and treatment-related side effects management.

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Section: Discussionmentioning

confidence: 99%

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Ciliberti¹,

Carbonara

Grillo³

et al. 2020

BMC Cancer

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“…Breast and lung are two of the most common malignancies to show cutaneous metastasis . The cytomorphology of the cutaneous metastasis showed a relatively monomorphic dyscohesive population of cells with plasmacytoid morphology and occasional nuclear inclusions.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic challenge in a metastatic pulmonary adenocarcinoma with neuroendocrine differentiation to breast and skin

et al. 2019

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Metastatic malignancy to the breast is a rare form of breast malignancy (<1% of all breast tumors) with difficult diagnosis and often dismal prognosis. 1,2 Melanoma, hematological malignancies and rhabdomyosarcoma commonly affect the breast secondarily although carcinomas of pulmonary, ovarian and renal origin are also reported to metastatize to the breast. 2,3 Metastatic deposits can be the presenting complaint to the patient and this becomes a diagnostic challenge for both the clinician and the pathologist. Such cases highlight the importance of the multidisciplinary diagnostic approach involving the physicians, radiologist and pathologist. | C A S E HIS TORYA 38-year-old married lady presented with nodular subcentimetric, firm to hard cutaneous lesions in the right inframammary region and right hand. The overlying skin could not be pinched off from the nodule. The lady was severely breathless at the time of examination. The lady presented with a right breast lump 12 months back for which she was biopsied elsewhere. The breast mass was reported from outside as infiltrating duct carcinoma, not otherwise specified in core needle biopsy. Fine needle aspiration cytology of the breast mass was not performed. She was referred to our institute as she developed progressive shortness of breath at that time approximately 3 weeks after the breast biopsy and was found to have an endobronchial mass in addition to the breast mass. An endobronchial biopsy from the lung mass was reported as adenocarcinoma with neuroendocrine differentiation. The patient was diagnosed with dual malignancy at that time and was managed accordingly. However, she was lost to follow-up. On examination at re-presentation, there was a hard lump involving the upper outer quadrant of her right breast approximately measuring 3 cm in diameter. This lump was separate from the cutaneous nodule in the right inframammary region.A fine-needle-aspiration cytology was performed from the right inframammary swelling and the swelling of the right hand with 22G needle and stained for May-Grünwald-Giemsa (MGG) and Hematoxylin and Eosin after air drying and alcohol fixation respectively. The slide and block of the breast biopsy was reviewed.Unfortunately, the patient succumbed to the illness and could not be contacted further. We could not obtain the images of the skin nodules either for the same reason.The cytology smears were highly cellular and showed a tumor in diffuse sheets and occasional small clusters. Scattered acinar/ rosette-like structures/punched-out spaces were also identified ( Figures 1A and B). The cell population was discreet and only focally showed cohesion. Individual cells were relatively monomorphic and showed sudden anisocytosis ( Figure 1C). These cells had eccentrically placed oval to round nuclei, vesicular to finely granular chromatin, inconspicuous to a few prominent nucleoli and moderate to abundant amount of cytoplasm ( Figure 1C). A few binucleate cells were noted. Occasional tumor cells showed intranuclear inclusions ( Figure 1C). The c...

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“…In the case of neoplasms, these include typical paraneoplastic syndromes, which themselves do not constitute neoplastic lesions [1,2]. More rarely, in the case of 1-12% of neoplasms, metastatic lesions from primary foci located in internal organs appear on the skin [2][3][4][5][6]. The involvement of the skin in the course of neoplastic diseases means that the neoplasm has gained access to the systemic circulation, which confirms its late stage and significantly worsens the prognosis.…”

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confidence: 99%

“…Non-small-cell carcinomas constitute 85% of diagnosed lung carcinomas [10]. It should be noted that every type of lung cancer can metastasize to the skin [6], and in 25% of patients with lung cancer the skin is the first place of metastases [8]. Some studies show the predominance of lung large-cell carcinoma as a primary tumour developing metastases in the skin [2,10].…”

mentioning

confidence: 99%

Primary skin manifestation of non-small-cell lung cancer – a case study

Grzywa-Celińska

Szmygin-Milanowska

Emeryk-Maksymiuk

et al. 2019

pdia

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Pathological processes involving internal organs can manifest themselves through a variety of skin lesions. In the case of neoplasms, these include typical paraneoplastic syndromes, which themselves do not constitute neoplastic lesions [1,2]. More rarely, in the case of 1-12% of neoplasms, metastatic lesions from primary foci located in internal organs appear on the skin [2-6]. The involvement of the skin in the course of neoplastic diseases means that the neoplasm has gained access to the systemic circulation, which confirms its late stage and significantly worsens the prognosis. The survival time of patients with metastases to the skin is usually less than 1 year [3,7]. An interesting phenomenon is the occurrence of a metastasis in the skin already involved in a neoplastic process, usually benign, which is referred to as a "tumour-to-tumour metastasis" [4].Cutaneous paraneoplastic syndromes can manifest under different forms, and usually include a variety of hyperkeratotic and sclerotic lesions. In the case of lung cancer, these are predominantly hyperkeratoses, including Bazex syndrome (cornification, nail eczema), ichthyosis acquisita, dermatomyositis and acanthosis nigricans [1]. Metastatic cutaneous lesions originating from lung cancer can take the form of hard, indolent, mobile, erythroid nodules covered with normal or inflamed skin. Typically, there is one or several nodules, but some cases include several hundred.We report a case of primary skin presentation of lung cancer in a 66-year-old male patient, an ex-smoker, who was admitted to the hospital in medium-severe condition due to general weakness, exercise-induced dyspnoea and dry cough. On admission to the department, in the subcutaneous tissue and on the skin of the patient, palpable and macroscopically visible nodules were observed, 2-3 cm in diameter, tender on palpation, of a rosy-bluish colour (Figure 1). These lesions were located on the front of the chest near a post-sternotomy scar, and in the dorsal area of the neck, as well as in the left supraclavicular, left-groin and left-thigh areas. The exanthems were of a polymorphic nature, and varied in terms of their size, colour and tenderness. As indicated by the patient, they appeared a month before admission to the department. During the patient's hospitalisation, new cutaneous lesions appeared and the old ones evolved. The lesion in the left groin area became spontaneously painful and showed signs of "fluctuation". The semi-liquid content was collected and sent for histopathological and bacteriological examination. A nodular lesion, 3 cm in diameter, appeared on the left side of the neck. The skin on the surface of the lesion was normal. Neck ultrasound revealed a mixed echogenic focal lesion and single neighbouring lymph nodes with preserved fatty hila. The submandibular and parotid glands were normal. Single nodules were also revealed in the thyroid area. Computed tomography of the chest performed 2 weeks before the hospitalisation revealed a tumour 8 cm in diameter in the right lung hilum....

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Skin metastases from lung cancer: a case report

Cited by 27 publications

References 22 publications

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Diagnostic challenge in a metastatic pulmonary adenocarcinoma with neuroendocrine differentiation to breast and skin

Primary skin manifestation of non-small-cell lung cancer – a case study

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