Multiple Cutaneous Metastases as Initial Presentation in Advanced Colon Cancer

Area of Science:

• Oncology
• Dermatology

Background:

• Colorectal cancer (CRC) is a common malignancy, but skin metastases are a rare occurrence, typically seen in advanced stages.
• Cutaneous metastases from CRC are reported in approximately 3% of advanced cases, often indicating widespread disease.

Observation:

• A 68-year-old woman with advanced ascending colon adenocarcinoma presented with multiple, rapidly progressing, painless cutaneous metastatic lesions.
• Notably, these skin lesions were the sole site of distant metastasis at the time of presentation.

Findings:

• This case represents an extremely rare instance of isolated, widespread cutaneous metastasis from ascending colon cancer.
• Cutaneous metastases can manifest as nodules or ulcers and, while uncommon in CRC, warrant consideration in differential diagnoses.

Implications:

• The presentation challenges the typical understanding of CRC metastasis patterns, emphasizing the need for vigilance in dermatological surveillance.
• While isolated cutaneous deposits may be amenable to radical management, multiple metastases necessitate palliative systemic chemotherapy, as initiated in this patient.