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A Clinicopathological and Immunohistochemical Correlation in Cutaneous Metastases from Internal Malignancies: A Five-Year Study

DOI: 10.1155/2014/793937

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Abstract:

Cutaneous metastases from internal malignancies are uncommon and occur in 0.6%–10.4% of all patients with cancer. In most cases, cutaneous metastases develop after the initial diagnosis of the primary internal malignancy and late in the course of the disease. Skin tumors are infrequent in Asian population and cutaneous metastases are quite rare. Cutaneous metastases carry a poor prognosis with average survival of few months. In the present five-year study 1924 malignant tumors were screened which included only nine cases of cutaneous metastatic deposits. A wide range of site and clinical presentations including nodules, plaques, and ulcers was noted. Histopathological findings were significant and corresponded with the primary internal malignancy. Cutaneous metastases from breast carcinoma (44.4%) were the most common finding followed by non-Hodgkin lymphoma and renal cell carcinoma (22.2% each) and carcinoma cervix (11.1%). The aim of our study is to classify the cutaneous metastases and to evaluate their clinicopathologic and immunohistochemical correlation with the primary tumor. 1. Introduction Cutaneous metastasis can be defined as the spread of a tumor from the site of its primary origin to the skin [1]. Skin metastasis may be the first sign of an advanced cancer or an indicator of cancer recurrence [2, 3]. Up to 9% of patients with cancer may develop skin metastases, while metastasis may develop more than 10 years after initial cancer diagnosis [3]. A wide morphologic spectrum of clinical appearances has been described in cutaneous metastases including nodules, plaques, papules, tumors, and ulcers [4]. While carcinomas are the most common type of cancer to metastasize, sarcomas, lymphomas, and leukemias also represent a substantial percentage of all skin metastases [5]. The relative frequencies of metastatic skin disease in each sex correlate with the frequency of different types of primary cancer. Thus women with the skin metastases have the following distribution in decreasing order of primary malignancies: breast, ovary, oral cavity, lung, and large intestine. In men, the distribution is as follows: lung, large intestine, oral cavity, kidney, breast, esophagus, pancreas, stomach, and liver [4]. Generally, cutaneous metastases herald a poor prognosis with average survival time of a few months. 2. Materials and Method In the present five-year study, patients diagnosed with an internal malignancy including hematolymphoid neoplasms, registered between March 2009 and March 2014 in the Pathology Department, were consecutively screened. The H&E

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