- CDC
- Heart Failure
- Cardiovascular Clinical Consult
- Adult Immunization
- Hepatic Disease
- Rare Disorders
- Pediatric Immunization
- Implementing The Topcon Ocular Telehealth Platform
- Weight Management
- Monkeypox
- Guidelines
- Men's Health
- Psychiatry
- Allergy
- Nutrition
- Women's Health
- Cardiology
- Substance Use
- Pediatrics
- Kidney Disease
- Genetics
- Complimentary & Alternative Medicine
- Dermatology
- Endocrinology
- Oral Medicine
- Otorhinolaryngologic Diseases
- Pain
- Gastrointestinal Disorders
- Geriatrics
- Infection
- Musculoskeletal Disorders
- Obesity
- Rheumatology
- Technology
- Cancer
- Nephrology
- Anemia
- Neurology
- Pulmonology
Cutaneous Metastasis
A 68-year-old man presented with a sudden-onset, 2.5 × 2-cm, rock-hard, erythematous, nontender nodule on the right side of the chest. A dense mat of telangiectases surrounded the solitary lesion. The remainder of the cutaneous examination was unremarkable.
A 68-year-old man presented with a sudden-onset, 2.5 × 2-cm, rock-hard, erythematous, nontender nodule on the right side of the chest. A dense mat of telangiectases surrounded the solitary lesion. The remainder of the cutaneous examination was unremarkable.
The differential diagnosis of the lesion, which was clearly a tumor, included both primary cutaneous neoplasia (particularly squamous cell carcinoma, nodular amelanotic melanoma, and various sarcomas) and cutaneous metastasis from an occult focus of an internal carcinoma. A biopsy revealed pleomorphic cells arranged in glandlike tubular structures embedded in a richly vascular stroma; this finding strongly suggested a renal cell carcinoma.
A thorough systemic evaluation revealed a primary tumor that involved the right kidney and asymptomatic hepatic and osseous metastases. The patient declined therapy and was lost to follow-up.
About 2% to 5% of all visceral malignancies result in cutaneous metastases.1 Of particular note: the first sign of renal cell and bronchogenic carcinomas may well be skin metastases.
REFERENCE:1. Rosen T. Cutaneous metastases. Med Clin North Am. 1980;64:885-900.
