SUBCUTANEOUS METASTASES OF MALIGNANT NEOPLASMS

Panagiotis Heras (1), Theodosis Andrianopoulos (1), Nikolaos Roussakis (1), Ioannis Tsiverdis (1), Ilias Georgopoulos (1),

Antonios Hatzopoulos (1)

 

(1) Clinic of Internal Medicine, General Hospital of Nafplio, GREECE

Introduction: The subcutaneous metastases of malignant neoplasms are the result of lymphatic or hematogenous spread and their prognosis is usually poor.

Materials and Methods: During the last five years 12 patients with metastases of malignant tumors in the sub cutis were admitted in our clinic. Among them, 9 (75%) were male and 3 (25%) were female, aged 56 to 85 years with a mean age of 68 years.

Results: In 8 of them subcutaneous metastases derived from epithelial tumors, whereas in 4 from mesenchymal tumors. The primary focus was in the colon (3 patients), the urinary tract (2 patients), the esophagus (1 patient), the lung (1 patient), and in the stomach (1 patient). As for the mesenchymal neoplasms, the primary tumor was retroperitoneal sarcoma (2 patients), Non-Hodgkin lymphoma (1 patient) and leiomyosarcoma of thigh (1 patient). The metastatic disease manifested 1 to 3 years after diagnosis of the primary tumor and in most cases it had the form of palpable painless subcutaneous nodules. The median survival was poor.

Conclusion: The subcutaneous metastases of malignant neoplasms are a relatively rare clinical entity and are typically associated with poor prognosis. In patients with a medical history of malignancy the thorough examination of cutaneous or subcutaneous lesions is particularly important in order to exclude their relationship with the primary tumor.