Clinicopathological Study on Metastatic Skin Cancer

Yi, Ji Hyun; Moon, Woo Sung; Yun, Seok Kweon; Kim, Han Uk; Ihm, Chull Wan

Abstract

BACKGROUND: Metastatic skin cancers are relatively uncommon, however, may forcast the diagnosis of internal malignancy. Therefore, early recognition can contribute to proper management.
OBJECTIVE
We studied patients with metastatic skin cancer to find out average age, gender distribution, frequency of primary tumor, time interval between manifestation and primary cancer, and their clinical appearance, location, other metastatic sites and survival time.
METHODS
We reviewed the medical records, clinical photographs and histopathologic records of 80 patients who had been diagnosed with metastatic skin cancer at the department of dermatology and pathology in Chonbuk National University Hospital during the last 19 years from January 1986 to December 2004.
RESULTS
The mean age at the time of diagnosis was 58.8 years. The ratio of men to women was 1.05:1. The most frequent primary tumors were breast cancer (20.0%), lung cancer (15.0%), colorectal cancer (8.8%), head and neck cancer (8.8%), and gastric cancer (8.8%). Lung cancer in men and breast cancer in women were the most common primary cancers. The sites of metastatic skin cancer were widespread over the whole body. However, the abdomen and chest were the most common sites for metastases, because most cutaneous metastases occur at body regions near the primary tumor. Metastatic skin cancers usually presented as discrete, painless, hard nodules, with sudden onset. However, we also found ulcers, inflammatory patches, plaques and cystic masses as clinical manifestations of metastatic skin cancer. The mean interval time between manifestation and primary tumor was 23.5 months. Histopathological findings indicated that adenocarcinoma was the most common pathologic type, followed by squamous carcinoma, melanoma and small cell carcinoma. Metastatic skin cancers revealed grave prognosis. The mean survival time after diagnosis of metastatic skin cancer was 9.9 months.
CONCLUSION
The incidence of metastatic skin cancer was much lower than in western countries, maybe because of genetic and racial differences. Overall incidence of common metastatic skin cancer was similar to that found in the literature, but our results showed a periodic difference according to primary cancer type, other organs metastasized, plus mean survival rate was 9.9 months, thereby confirming a poor prognosis of metastatic skin cancer.