Study of Cutaneous Metastases, Experience from Tertiary Cancer Center
Kanchan Kantekure, Dinesh Sariya, Stuart Lessin, Hong Wu. Fox Chase Cancer Center, Philadelphia, PA
Background: It is very important for pathologists to recognize cutaneous metastasis from systemic malignancies. Due to variable appearances, clinical lesions can mimic dermatoses or primary skin tumors. There is also a wide range of histopathologic features. We analyzed clinicopathological characteristics of cutaneous metastases.
Design: Retrospective study of 141 patients with biopsy-proven cutaneous metastases from systemic malignancies (excluding that of hematologic or skin cancers) seen over a 20-year period in a cancer center.
Results: 141 cases with biopsy-proven cutaneous metastases (57 men and 84 women). Breast cancer was the most common cause (33/84) in women; lung cancer in men (12/57). Most of the skin metastases occurred in patients with known advanced stage of malignancy (60% cases occurred in patients with stage IV disease). However, cutaneous lesion was the presenting sign prior to a known cancer diagnosis in 11% cases. The most common site of metastasis was abdominal skin (34%), chest (30%) & head & neck (20%). Due to unusual clinical presentations, 46% of the lesions were not suspected of being cutaneous metastases at the time of biopsy. A high percentage (48%) of patients with cutaneous metastases died of underlying malignancy. Mean survival was 17 months (3 -155 months) after diagnosis of cutaneous metastases. Histologically, the common patterns are nodular tumor or infiltrative growth in a fibrotic dermis. Lymphovascular invasions are not invariably identifiable.
Conclusions: Cutaneous metastasis has variable appearance clinically and histopathologically. Although most commonly seen in patients with an existing diagnosis, it can be the presenting lesion in some patients. Metastatic adenocarcinomas can in general be easily distinguishable from a primary skin tumor. However, there are difficult cases that require clinicopathologic correlation and/or immunohistochemical studies. In the absence of a known primary tumor, it is often difficult to assign a tissue of origin of the metastasis based on histology alone.
Wednesday, March 6, 2013 9:30 AM
Poster Session V # 67, Wednesday Morning