Cancer Res Treat.  2012 Jun;44(2):142-145.

Metastatic Skin Lesions on Lower Extremities in a Patient with Recurrent Serous Papillary Ovarian Carcinoma: A Case Report and Literature Review

• Kim MK
• Kim SH
• Lee YY
• Choi CH
• Kim TJ
• Lee JW
• Lee JH
• Bae DS
• Kim BG

Abstract

Clinical observation of skin metastasis in ovarian cancer cases is relatively uncommon. And distant metastatic skin lesions including the extremities are much rarer still as most metastatic skin lesions are located in the skin in the abdominal wall adjacent to where the primary ovarian tumors exist. We report the case of a 60-year-old woman who presented skin lesions on both lower extremities as a consequence of the metastasis of serous papillary adenocarcinoma of the ovary. She presented with erythematous and painful cutaneous nodules on both upper legs and in the inguinal area 42 months after initial diagnosis of ovarian cancer. Skin biopsy revealed metastasis of adenocarcinoma in the dermis. She was treated with surgical excision and systemic chemotherapy. Literature review has suggested that a combined modality approach including surgical excision and chemotherapy may be useful in the management of skin metastases due to ovarian cancer.

Keyword

Drug therapy; Neoplasm metastasis; Ovarian neoplasms; Palliative care; Skin neoplasms

MeSH Terms

Abdominal Wall
Adenocarcinoma
Adenocarcinoma, Papillary
Biopsy
Dermis
Extremities
Female
Humans
Leg
Lower Extremity
Middle Aged
Neoplasm Metastasis
Ovarian Neoplasms
Ovary
Palliative Care
Skin
Skin Neoplasms

Figure

• 

  Fig. 1 Skin lesions due to metastatic adenocarcinoma of the ovary in the right thigh (A) and right inguinal area (B) with multiple lymphatic spaces in the dermis infiltrated by metastatic adenocarcinoma (C, H&E staining, ×40; D, H&E staining, ×100).

Reference

1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009; 59:225–249. PMID: 19474385.

2. Dauplat J, Hacker NF, Nieberg RK, Berek JS, Rose TP, Sagae S. Distant metastases in epithelial ovarian carcinoma. Cancer. 1987; 60:1561–1566. PMID: 3621129.

3. Brownstein MH, Helwig EB. Metastatic tumors of the skin. Cancer. 1972; 29:1298–1307. PMID: 4336632.

4. Kim YJ, Kim SK, Kim HD, Cho MK, Park YL, Lee JS, et al. A case of skin metastasis of ovarian cancer (mucinous cystadenocarcinoma). Korean J Dermatol. 2010; 48:342–345.

5. Kwon SY, Hur YM, Park HK, Nam KH, Jin SY, Lee MC, et al. A case of recurrent ovarian carcinoma metastasizing to umbilical skin mass. Korean J Obstet Gynecol. 1992; 35:1528–1532.

6. Cheng B, Lu W, Xiaoyun W, YaXia C, Xie X. Extra-abdominal metastases from epithelial ovarian carcinoma: an analysis of 20 cases. Int J Gynecol Cancer. 2009; 19:611–614. PMID: 19509558.

7. Cormio G, Capotorto M, Di Vagno G, Cazzolla A, Carriero C, Selvaggi L. Skin metastases in ovarian carcinoma: a report of nine cases and a review of the literature. Gynecol Oncol. 2003; 90:682–685. PMID: 13678747.

8. Spencer PS, Helm TN. Skin metastases in cancer patients. Cutis. 1987; 39:119–121. PMID: 3829718.

9. Tharakaram S. Metastases to the skin. Int J Dermatol. 1988; 27:240–242. PMID: 3391711.

10. Braverman IM. Cutaneous signs of systemic disease. Med Times. 1977; 105:82–95. PMID: 875677.

11. Krumerman MS, Garret R. Carcinomas metastatic to skin. N Y State J Med. 1977; 77:1900–1903. PMID: 270017.

12. Cormio G, Rossi C, Cazzolla A, Resta L, Loverro G, Greco P, et al. Distant metastases in ovarian carcinoma. Int J Gynecol Cancer. 2003; 13:125–129. PMID: 12657111.

13. Patsner B, Mann WJ, Chumas J, Loesch M. Herpetiform cutaneous metastases following negative second look laparatomy for ovarian adenocarcinoma. Arch Gynecol Obstet. 1988; 244:63–67. PMID: 3240006.

14. Tapley ND. Radiation therapy with the electron beam. Semin Oncol. 1981; 8:49–58. PMID: 6787709.