Elephantiasis-like cutaneous metastases from signet-ring cell carcinoma of the stomach

We report the clinical features and course of a 66-year-old patient with gastric carcinoma, in whom multiple cutaneous metastases occurred one year after he underwent subtotal gastrectomy. Although internal malignancies rarely metastasize to the skin, when they do this may have profound diagnostic, therapeutic, and prognostic significance. Cutaneous metastases are usually synonymous with a rapidly progressive disease and a poor prognosis. This case, in which cutaneous metastases were found in the lower limbs, is notable since usually less than 4 percent of cutaneous metastatic lesions are found in this region. Moreover, the case seems unique because of the predominating dermiotrophic metastases, with only minor internal involvement.