Track
Case ReportsAbstract
Lung cancer is the second most common malignancy in the United States with a high rate of metastasis. The most sites of metastasis include the brain, bone, and liver. The incidence of cutaneous metastases is rare and varies from 1-12%. The lesion typically presents nodular, mobile/fixed, hard/flexible, single/multiple, and/or painless. We report a case of a lung adenocarcinoma with metastasis to the skin that clinically mimics scleroderma. A 72-year-old-female with a history of primary lung adenocarcinoma presented to the dermatologist with a 25cm pink annular thin plaque with a slight peau d’orange texture and an underlying indurated ill-defined tender component that started on a small area of the abdomen over 3 months prior to admission and rapidly expanded to its current size within a week. The initial impression was scleroderma/morphea. Skin biopsy revealed adenocarcinoma and immunohistochemistry (IHC) was positive for TTF-1, MOC-31, and Napsin A, suggestive of a lung-primary cutaneous metastasis. There have been reported cases of cutaneous metastasis of inflammatory breast cancer presenting as scleroderma-like lesions. However, this is a novel case of such a clinical presentation in a metastasized cutaneous lung adenocarcinoma. This diagnosis is entirely dependent on histology with IHC confirmation. Prompt recognition of cutaneous metastases is crucial, as their presence may hint at other organ involvement and warrant systemic work-up. Additionally, the response of the lesion to therapy can be used to monitor the response of the entire malignancy, potentially prolonging patients’ lives.