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Cutaneous Metastasis: A Single Institution Clinical and Histopathologic Experience
Author(s) -
Sariya D.,
AdamsMcDonnell R.,
Cusack C.,
Xu X.,
Elenitsas R.,
Seykora J.,
Pasha T.,
Zhang P.,
Baldassano M.,
Lessin S.,
Wu H.
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320gm.x
Subject(s) - medicine , metastasis , pathology , biopsy , lung , immunohistochemistry , stage (stratigraphy) , cancer , paleontology , biology
Forty‐four cases of biopsy‐proven cutaneous metastases from internal organ or soft tissue malignancies were retrieved at a single institution from 1990 to 2004. All cases had detailed clinical and follow‐up data. There were 19 males and 25 females, with a wide age range (37–86 years). Most (75%) had advanced (stage IV) disease at the time of metastasis. In four patients skin metastasis was the presenting lesion. The most common primary site for men is lung and for women, breast and lung. In nearly half of patients cutaneous metastasis was not the clinical diagnosis. The prognosis was grave (67% died of disease within a median of 7 months). Independent, blinded review by four dermatopathologists showed that without a detailed clinical history, most metastases from carcinomas were correctly suspected based on histologic patterns. However, metastases from small cell carcinomas and sarcomas were difficult to distinguish from primary skin tumors. Histologic recognition of a primary site was often difficult without pertinent clinical history. None of the metastasis had a combined immunohistochemical profile of B72.3 (−), CA125 (−), calretinin (+), p63 (+) and CK5/6 (+), which was commonly seen in skin adnexal tumors. This immunohistochemical panel appears to best differentiate the two entities.