A Clinicopathological Analysis of Cutaneous Metastasis from Gastric Cancer in Korea

Kim, Myoung Shin; In, Seung Gyun; Won, Chong Hyun; Chang, Sung Eun; Lee, Mi Woo; Choi, Jee Ho; Moon, Kee Chan

Abstract

BACKGROUND
Cutaneous metastasis from an internal malignancy is uncommon and it usually arises from the breast and lung. Cutaneous metastasis from gastric cancer is rarely seen, although gastric cancer is the most common internal cancer in Korea.
OBJECTIVE
The purpose of this study was to analyze the clinical and histopathological characteristics of cutaneous metastasis from gastric cancer in Korea.
METHODS
Twenty-seven cases of cutaneous metastasis from gastric cancer were included in the study among the 14,053 patients who were diagnosed with gastric adenocarcinoma over a 20 year period. Their medical records and pathology slides were retrospectively reviewed.
RESULTS
The incidence of cutaneous metastasis was 0.19% (27/14,053). The age of the 27 patients ranged from 28 to 75, and the mean age was 53.9 with no significant difference in gender. The most frequently involved site was the abdomen followed by the face and scalp. Nodular lesion was most common (55.6%, 17/27) and inflammatory and indurated lesions were 25.9% (7/27) and 7.4% (2/27), respectively. Histopathologically, poorly differentiated adenocarcinoma (13/27) and signet-ring cell carcinoma (10/27) were common, which comprised 85.1% of the total tumor. In 7 cases (25.9%), skin lesion was the first presenting sign of gastric cancer or metastatic gastric cancer. The mean survival of the patients was 4.7 months.
CONCLUSION
Cutaneous metastasis from gastric cancer is rare despite gastric cancer's high prevalence as a primary cancer in Korea. It was frequently observed in patients with an advanced disease stage, yet it may represent the initial manifestation of the disease. Dermatologists can contribute to the management of patients with cutaneous metastasis by performing early detection and recognition of skin lesions.