Zosteriform cutaneous metastases from urothelial carcinoma: Report of a rare case and literature review

Abstract

Zosteriform cutaneous metastases from urothelial carcinoma are rare. Here, we report a 50-year-old male with urothelial carcinoma who presented with multiple tender, erythematous papulonodules in an L1-L3 distribution approximately 6 years after primary tumor diagnosis. He had no history of prior herpes zoster infection. Histopathology showed lobules and small nests of atypical epithelioid cells positive for GATA3, CK20, CK7, and p40 throughout the dermis and within lymphatic vessels highlighted by D2-40, consistent with cutaneous metastases from urothelial carcinoma. No perineural invasion or viral cytopathic change was present. The patient died approximately 8 months after diagnosis of cutaneous metastases. Since its first report in 1986, there have been only six cases of zosteriform cutaneous metastases from urothelial carcinoma. We review the prior literature including hypotheses of the pathogenesis of zosteriform cutaneous metastases, which remain incompletely understood.

Cutaneous metastasis of urothelial carcinoma

“…Interestingly, there are many cases of zosteriform or dermatomal eruptions of cutaneous metastasis. 9 , 10 There are a total of seven cases of zosteriform cutaneous metastasis of urothelial carcinoma in the literature to date. 10 Our case is helpful in describing the rare presentation of urothelial carcinoma presenting in a dermatomal distribution.…”

“… 9 , 10 There are a total of seven cases of zosteriform cutaneous metastasis of urothelial carcinoma in the literature to date. 10 Our case is helpful in describing the rare presentation of urothelial carcinoma presenting in a dermatomal distribution. One differentiating factor between a shingles outbreak and zosteriform cutaneous metastasis is the presence of markedly firm nodules and a lack of vesicles, as seen in our patient.…”