Cutaneous Metastases of Signet-Ring Cell Gastric Carcinoma: A Case Report

The cutaneous metastases from carcinoma of the stomach are rare and either an index of a silent visceral neoplasm or a recurrence of an already diagnosed malignancy. They usually present as asymptomatic nodules or plaques; thus, they can be mistaken for other skin conditions, which leads to a potential misdiagnosis. The definition of signet-ring cell (SRC) gastric carcinoma is that it can easily cause a diffusion enbloc through lymphatic and hematogenous pathways, inducing skin manifestations such as indurated plaques, nodules, and erysipelas-like lesions. The infrequency of skin metastasis from gastric carcinoma underlines once more the need for increased awareness on the part of clinicians. Diagnosis, histopathological examination, and immunohistochemistry are essential. The confirmation of SRC tumors is done by staining for mucin, such as periodic acid-Schiff (PAS) and mucicarmine, and by using immunohistochemical markers like CK7. Almost always, cutaneous metastasis from SRC gastric carcinoma has a poor prognosis since these tumors are highly aggressive and chemotherapy-resistant. We present a case of cutaneous metastasis from SRC gastric carcinoma, a subtype of gastric cancer with a well-documented tendency both for distant and cutaneous spread. Generally, skin metastases from SRC gastric carcinoma are associated with poor prognosis, rapid progression of the disease, and a high mortality rate. This case underlines the need for early detection and a multidisciplinary approach by dermatologists, oncologists, and surgeons to improve outcomes in such patients.