Lehman Julia S, Benacci Joseph C
Transitional Residency Program, Gundersen Lutheran Medical Center, 1900 South Ave, La Crosse, WI 54601, USA.
Cutis. 2008 Mar;81(3):223-6.
Cutaneous metastasis of a primary internal malignancy is a relatively common phenomenon, occurring in up to 10% of patients with noncutaneous cancer. Cutaneous metastasis can occur via direct extension, hematologic or lymphatic dissemination, or surgical implantation. The most common internal malignancy associated with the development of cutaneous metastases in females is breast cancer. We present a patient with widely metastatic invasive ductal carcinoma of the breast, status postpalliative mastectomy and chest wall coverage with a vertical rectus abdominus myocutaneous flap, who acquired cellulitis and, subsequently, noncontiguous cutaneous metastasis of her breast cancer to the site of her central venous access device (ie, infusaport). We hypothesize that the local inflammation associated with her recent bout of cellulitis and operations, in conjunction with the presence of a foreign body, may have predisposed the infusaport site to seeding by metastatic tumor cells. This case highlights the importance of considering cutaneous metastasis in the differential diagnosis of new skin eruptions in patients with cancer.
原发性体内恶性肿瘤的皮肤转移是一种相对常见的现象，在高达10%的非皮肤癌患者中会出现。皮肤转移可通过直接蔓延、血液或淋巴扩散或手术植入发生。女性中与皮肤转移发生相关的最常见体内恶性肿瘤是乳腺癌。我们报告一名患有广泛转移性乳腺浸润性导管癌的患者，该患者接受了姑息性乳房切除术后，采用腹直肌肌皮瓣覆盖胸壁，之后发生了蜂窝织炎，随后其乳腺癌非连续性皮肤转移至中心静脉通路装置（即输液港）部位。我们推测，与她近期的蜂窝织炎发作和手术相关的局部炎症，加上异物的存在，可能使输液港部位易被转移性肿瘤细胞播散。该病例突出了在癌症患者新发皮疹的鉴别诊断中考虑皮肤转移的重要性。
