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Specific cutaneous manifestations of internal malignancy.
1University of California, Los Angeles.
Advances in Dermatology
|January 1, 1986
Summary
Cutaneous metastases, including specific patterns like Sister Mary Joseph
Area of Science:
- Oncology
- Dermatology
- Pathology
Background:
- Carcinomas are the most frequent cancers to metastasize to the skin, with lung cancer in men and breast cancer in women being most common.
- Distinctive clinical patterns of cutaneous metastasis include alopecia neoplastica, pulsatile nodules, Sister Mary Joseph's nodules, morpheaform, and cellulitis-like lesions.
- Leukemia and lymphoma can also manifest in the skin, presenting with characteristic lesions and requiring specific diagnostic approaches.
Purpose of the Study:
- To review the characteristic clinical and histological patterns of various internal malignancies that metastasize to the skin.
- To highlight the importance of recognizing these cutaneous signs for early diagnosis and improved patient management.
- To differentiate between primary skin cancers and secondary metastatic disease.
Main Methods:
- Review of clinical presentations and histopathological findings of cutaneous metastases from various internal malignancies.
- Correlation of specific skin lesion types with their presumed organ of origin.
- Discussion of diagnostic challenges and the utility of ancillary studies like cellular marker analysis and immunoelectrophoresis.
Main Results:
- Biopsies of cutaneous metastases often reveal adenocarcinoma, squamous cell carcinoma, or anaplastic carcinoma, providing clues to the primary tumor.
- Specific leukemias (chronic lymphocytic leukemia, acute myeloid leukemia) and lymphomas present with characteristic skin lesions.
- Multiple myeloma, Letterer-Siwe disease, neuroblastoma, and Kaposi's sarcoma also have distinct cutaneous manifestations.
Conclusions:
- Recognizing specific patterns of skin lesions is crucial for identifying internal malignancies.
- Histological examination of skin biopsies, alongside lymphoid tissue patterns and cellular markers, aids in diagnosis.
- Familiarity with these cutaneous clues enables clinicians to improve the management of cancer patients.