|LETTER TO EDITOR
|Year : 1998 | Volume
| Issue : 1 | Page : 41-42
Metastatic cutaneous adenocarcinoma
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sharma N. Metastatic cutaneous adenocarcinoma. Indian J Dermatol Venereol Leprol 1998;64:41-2
| To the Editor|| |
A 60-year-old male presented with an asymptomatic erythematous lesion over right side of the forehead of one month duration. Patient was apparently healthy except for moderate degree of prostatism for last 2-3 years. On examination, a firm indurated plaque of 3x4cms size was present over right forehead involving right eye brow without any ulceration or eczematization. There was softening of the underlying bones of the forehead and orbit on the right side. X-ray of the skull showed large osteolytic lesion involving frontal bones and roof and lateral wall of the orbit on the right side just beneath the plaque lesion. Biopsy from the lesion showed poorly differentiated adenocarcinoma where cell of origin could not be ascertained. A thorough search with good clinical examination was done to locate primary site of adenocarcinoma. Skeletal survey of long bones and spine did not reveal any osteolytic lesions. A complete blood count, urine analysis, hepatic and renal function, serum acid phosphatase and x-ray chest were normal. A fine needle aspiration cytology from the prostate did not reveal any malignant focus. On learning about the diagnosis of cancer, the patient left for alternative system of medicine to seek cure and was lost to follow-up.
The skin is involved by metastases in 3-4% of malignant tumors. Most frequent sites of primary tumour being breast, stomach, lung, uterus, large intestine, kidney, prostate glands, ovary, liver and bones. Lesions of cutaneous metastases are usually erythematous than normal skin and with marked induration resembling an inflammatory lesion. Cutaneous metastasis is usually a late and bad prognostic event. [2, 3] Reingold reported a series in which survival time was not more than 3 months on the average from the time of diagnosis of cutaneous deposits. It is likely that in present patient skin was involved secondary to the bone metastases as the cutaneous lesion was overlying the bone involved. Because of the undifferentiated nature of the metastases and unwillingness of patient to continue treatment, the primary site of malignancy could not be ascertained. But it is likely that these metastases could have arisen from prostrate because bone involvement in prostatic carcinoma is not uncommon.
| References|| |
|1.||Mackie RM. Soft tissue tumours. In: Editors Champion RH, Burton JL, Ebling FJG. Textbook of Dermatology Blackwell scientific Publications, Oxford 1992; 2099-2100. |
|2.||Brownstein MF, Helwig EB. Pattern of cutaneous metastases, Arch Dermatol 1972; 105:862-868. |
|3.||Peison B. Metastases of carcinoma of prostate to the scalp, Arch Dermatol 1971;104:301-303. [PUBMED] [FULLTEXT]|
|4.||Reingold IM, Cutaneous metastases from internal carcinoma Cancer, 1966;19:162-168. |