100
Cutaneous Metastases
• Relatively rare with the exception of breast cancer and melanoma metastases.
• May be the presenting sign of a malignancy.
• Often associated with a poor prognosis.
• Overall, breast carcinoma most commonly metastasizes to the skin and prostate carcinoma least commonly (Table 100.1).
Table 100.1
Percentages of patients with metastatic cancer who had cutaneous metastases.
| Primary Malignancy | Patients with Metastatic Disease (n = 4020) | Patients with Cutaneous Metastases (n = 420; 10%) |
| Melanoma | 172 | 77 (45%) |
| Breast | 707 | 212 (30%) |
| Squamous cell carcinoma of the head and neck (e.g. laryngeal, oral) | 221 | 29 (13%) |
| Colon/rectum | 413 | 18 (4.5%) |
| Lung | 802 | 21 (2.5%) |
| Prostate | 207 | 0 |
Adapted from Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: A retrospective study of 4020 patients. J. Am. Acad. Dermatol. 1993;29(2 Pt 1):228–236.
• Most common skin metastases: women – breast carcinoma, melanoma; men – melanoma, squamous cell carcinoma of the head and neck and lung, and colon carcinoma (Table 100.2).
Table 100.2
Ranking of underlying primary malignancies in patients with cutaneous metastases – men versus women.
Adapted from Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: A retrospective study of 4020 patients. J. Am. Acad. Dermatol. 1993;29(2 Pt 1):228–236.
• In general, nonspecific morphology: firm, mobile, painless papulonodule(s), often skin-colored to pink or red-brown and occasionally ulcerated (Fig. 100.1).
