Unusual site of skin metastasis from lung adenocarcinoma A case report

Abstract

Background: Skin metastasis incidence is approximately 3,4% of lung cancer with highest incidence in man. It arises mostly in man from primary cancer of the lung (24%), colon (19%), melanoma (13%) and oral cavity (12%). In woman, it arises from breast (69%), colon (9%), melanoma (5%), ovaries (4%) and lung (4%) primary cancer. It may occur at the same time or before the primary cancer detected.

Case Illustration: Forty-sixth years old male referred with lesion found in chest x-ray during the medical check-up procedure. Nodules arose at parietal and abdomen region since three months prior. Chest CT scan revealed a solid 6,4 cm mass in long axis at the medial of left lung lobe. Head CT scan revealed subsolid nodule at cutaneous-subcutaneous of the left occipital attached to the periosteum without bone destruction and solid nodule at cortex-subcortex of right frontoparietal accompanied by perifocal edema. Bronchoscopy procedure found edematous mucosa of left B1 to B3 orificium. Histopathology and cytology examination confirmed adenocarcinoma with wild-type EGFR mutation.

Discussion: Preference site of lung cancer skin metastasis is at supra-diaphragm region. Nodules are usually firm, painless and appear as oval or round form. Ulceration may be seen. In our case, the lesion were ulcerate with granulation tissue at the edge and black scars form containing necrotic tissue. Adenocarcinoma is the most common type of lung cancer with skin metastases.

Conclusion: It is essential to consider any skin pathological form in patient with lung adenocarcinoma as skin metastases.