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Cutaneous metastases of internal malignancies: an experience from a single institution

  • Clinical report
  • Published:
European Journal of Dermatology

Abstract

Background

Cutaneous metastases represent 2% of all skin tumours. Their recognition can be challenging, as they may present with different clinical features, with consequent frequent delay and failure in diagnosis.

Objectives

To review our series of cutaneous metastatic lesions, analyse their frequency according to patient gender, histotype, localization of the primary tumour, and site of cutaneous metastasis, and correlate this data with clinicopathological parameters.

Materials & methods

We conducted a retrospective review of all cases of cutaneous metastases from visceral neoplasms diagnosed in our dermatopathology department from July 2003 to February 2017. We registered clinical, histological, and immunohistochemical data. Additional immunohistochemical staining panels were elaborated to confirm or identify the origin of the primary tumour, or at least to specify the histological subtype.

Results

We identified 45 histological diagnoses of cutaneous and mucocutaneous metastases. The primary tumour that was most likely to metastasize to the skin was breast cancer. Most cases of breast (89%) and lung cancer (86%) metastasized to the trunk. Of the lesions, 57.5% were nodules and 32.5% were plaques, more frequently multiple (64.4%). In 58% of cases, a metastasis was clinically suspected. Histological examination most frequently revealed an adenocarcinoma, sometimes suggestive of the site of origin.

Conclusions

Cutaneous metastases should be primarily considered when discrete firm painless nodules emerge rapidly. Clinicians should carefully consider infiltrated lesions of the chest in women since scleroderma and erysipelas-like presentation can be a clue for undiagnosed breast cancer.

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Authors and Affiliations

  1. Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, IRCCS Fondazione Ca’ Granda - Ospedale Maggiore Policlinico, via Pace 9, 20122, Milano, Italia

    Elena Guanziroli, Stefano Veraldi & Raffaele Gianotti

  2. Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, UOC Dermatologia via Pace 9, 20122, Milano, Italia

    Antonella Coggi, Daniele Fanoni & Emilio Berti

  3. Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milano, Italia

    Luigia Venegoni & Emilio Berti

  4. Unità Operativa di Anatomia Patologica, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122, Milan, Italy

    Giulia Ercoli, Francesca Boggio, Stefano Ferrero & Alessandro Del Gobbo

  5. Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, via Francesco Sforza 35, 20122, Milan, Italy

    Stefano Ferrero

Authors
  1. Elena Guanziroli
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  2. Antonella Coggi
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  3. Luigia Venegoni
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  4. Daniele Fanoni
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  5. Giulia Ercoli
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  6. Francesca Boggio
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  7. Stefano Veraldi
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  8. Emilio Berti
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  10. Stefano Ferrero
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  11. Alessandro Del Gobbo
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Corresponding author

Correspondence to Elena Guanziroli.

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Guanziroli, E., Coggi, A., Venegoni, L. et al. Cutaneous metastases of internal malignancies: an experience from a single institution. Eur J Dermatol 27, 609–614 (2017). https://doi.org/10.1684/ejd.2017.3142

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  • DOI: https://doi.org/10.1684/ejd.2017.3142

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