Skin - Nonmelanocytic tumors
Carcinoma (non-adnexal)
Metastatic carcinoma to skin

Author: Ghassan Tranesh, M.D. (see Authors page)
Editor: Hong Qu, M.D.

Revised: 13 October 2016, last major update November 2014

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Metastatic carcinoma [title] skin

Cite this page: Metastatic carcinoma to skin. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/skintumornonmelanocyticmetastaticcarcinoma.html. Accessed December 3rd, 2016.
Definition / General
  • Cutaneous metastases from many internal organ sites or soft tissue sarcomas are uncommon (J Surg Case Rep 2014 Sep 9;2014)
  • Men: usually from lung (25%), colon, melanoma, kidney, upper aerodigestive tract
  • Women: usually from breast (69%), lung, melanoma, kidney, ovary
  • Metastasis is often close to site of primary
Sites
  • Local recurrence / regional metastasis most commonly occurs upon anterior chest wall
  • Scalp is tmost commonly observed distant metastatic site
Case Reports
  • 73 year old woman with cutaneous metastases as only sign of extranodal tumor spread (ISRN Surg 2011;2011:902971)
  • 83 year old woman with herpetiform cutaneous metastases from transitional cell carcinoma of bladder (J Clin Pathol 2006;59:1331)
  • 91 year old woman with seven month history of redness and swelling around her right eye (BMJ 2007;334:1228)
Treatment
  • Treat underlying malignancy, possible excision of metastasis
Clinical Images

Images hosted on PathOut server:

Metastatic breast carcinoma
courtesy of Mark R. Wick, M.D.



Images hosted on other servers:

Cutaneous metastases

Gross Description
  • Often multiple, firm, nonulcerated nodules, but may be solitary
Micro Description
  • Poorly differentiated adenocarcinoma within dermis and often underlying subcutaneous tissue
  • Tumor cells in sheets or clusters or as single detached cells
  • Either abortive gland formation or "signet ring" cells (with central, cleared mucin-filled space which compresses and marginalizes the cell nucleus)
  • Tumor cells may show a "single file" appearance (metastatic lobular breast carcinoma)
  • Cytologic atypia in small to large epithelioid cells, often with striking nuclear pleomorphism
  • Tumor cells may produce mucin, or mucinous debris may separate collagen bundles
  • Variable desmoplasia or sclerosis of dermal collagen
Micro Images

Images hosted on PathOut server:

Metastatic breast carcinoma
courtesy of Mark R. Wick, M.D.



Images hosted on other servers:

Metastatic bladder urothelial carcinoma

Renal cell carcinoma-metastatic

p63- metastatic adenocarcinoma

Positive Stains
Negative Stains
  • Negative immunostains for metastatic breast adenocarcinoma are S100 (positive in melanoma), TTF1 (positive in lung adenocarcinoma), CK20 and CDX2 (positive in colon adenocarcinoma)
Differential Diagnosis