Head and neck squamous cell carcinoma skin metastases below of the diaphragm

Cutaneous metastases from carcinoma are relatively uncommon in clinical practice. Metastasis to skin sites from squamous cell carcinoma of the mucosa of the head and neck are also very rare. However, skin metastases may be the first clinical evidence of the malignant disease or its loco-regional recurrence. Early recognition of skin metastasis can lead to an accurate and prompt diagnosis and timely treatment. Patients with skin metastases have very poor prognosis. We report on four such patients, one of them with multiple skin metastases from the squamous cell carcinoma in the cervical part of the esophagus above and below the level of the diaphragm. In reviewing the literature, only two cases of solitary skin metastases below the diaphragm from laryngeal squamous cell carcinomas have been reported