Track: Case Reports

Abstract:

Inflammatory carcinoma, also known as carcinoma erysipeloides, is a cutaneous manifestation of metastatic carcinoma thought to be secondary to tumor cell obstruction of lymphatic vessels. Although frequently associated with breast cancer, other malignancies may also present as inflammatory carcinoma. To our knowledge, inflammatory carcinoma in the setting of endometrial carcinoma—the most common gynecological malignancy—has only rarely been described in the literature. We present a 41-year-old female who presented with six weeks of a flat, pruritic, erythematous, reticulated rash on the right thigh that was preceded by chronic swelling and deep pain in that area. The patient had a history of metastatic endometrial carcinoma, treated with six cycles of carboplatin-paclitaxel and trastuzumab followed by five cycles of lenvatinib-pembrolizumab. The clinical differential of the rash included post-inflammatory erythema/hyperpigmentation, contact dermatitis, vasculopathy, and erythema ab igne. A punch biopsy was performed for further evaluation, with H&E and immunostained sections demonstrating PAX8-positive islands of tumor cells with central necrotic debris located in dilated lymphatic vessels (highlighted with D2-40 immunostain). In light of these findings, patient’s presentation was attributed to inflammatory carcinoma in the setting of endometrial carcinoma. This case highlights the importance of considering cutaneous metastases in patients with a history of malignancy, even in the differential of presumed inflammatory dermatoses.

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