Lung cancer with skin metastasis

Cutaneous metastasis from lung cancer is rare, but physicians should understand its significance. We treated eight such patients during a 30-month period at Wilkes-Barre (Pa) General Hospital. The seven men and one woman ranged in age from 46 to 72 years (mean, 59 years). In three, the skin lesion was the first manifestation of the underlying cancer and in another three, it was found coincident with the lung mass. Pathologic findings included small-cell undifferentiated carcinoma in four patients, squamous cell carcinoma in three patients, and large-cell undifferentiated carcinoma in one patient. Seven of the eight primary lung lesions were in the upper lobes. Six patients had clinically occult visceral metastases at the time of skin biopsy. Only one patient survived more than six months following skin metastasis. Biopsy specimens must be taken from all new skin lesions, particularly in patients who smoke or who already have a history of lung cancer.