Lung cancer with skin metastasis

We describe findings in 34 cases of lung cancer with skin metastases. In 24 men and 10 women, ages ranged from 32 to 85 years (mean, 61 years). In five, a skin lesion was the first manifestation of the underlying cancer; in another four, it was found coincidentally with detection of the lung mass. Pathologic findings included adenocarcinoma in 18 patients, large-cell carcinoma in 9, squamous cell carcinoma in 5, and small-cell carcinoma in 2. Among 87 patients with large-cell carcinoma, 9 (10.3 percent) developed cutaneous metastases. A review of 510 autopsies of primary lung cancer at Keio University from 1958 to 1992 showed 25 cases with skin metastases (4.9 percent), adenocarcinoma in 13 cases, large-cell carcinoma in 6, squamous cell carcinoma in 4, and small-cell carcinoma in 2. Skin metastases were proven in 15.4 percent of autopsy cases of large-cell carcinoma of the lung. Mean survival time from diagnosis of lung cancer was 10.3 months and that from diagnosis of skin metastasis was 4.9 months. The prognosis for patients having lung cancer with skin metastasis is thus very poor. In the review of 34 patients and 25 autopsies of lung cancer with skin metastasis, we conclude that the incidence of cutaneous metastasis is high for large-cell carcinoma and low for squamous and small-cell carcinoma.