Nashan Dorothée, Müller Marcel Lucas, Braun-Falco Markus, Reichenberger Sebastian, Szeimies Rolf-Markus, Bruckner-Tuderman Leena
Department of Dermatology, University Medical Center Freiburg, Hauptstr. 7, 79104, Freiburg, Germany.
J Cancer Res Clin Oncol. 2009 Jan;135(1):1-14. doi: 10.1007/s00432-008-0432-0. Epub 2008 Jun 17.
Up to 10% of all visceral malignancies develop cutaneous metastases. As cutaneous metastases are underestimated and underdiagnosed they can be a clinical challenge. The clinical appearance and patterns of distribution of cutaneous metastases, the characterisation of clinical outcomes and available therapeutic options are compiled.
Literature (over the last 6 years) MESH in terms of cutaneous metastases was comprehensively evaluated. Characteristics from 92 available cases are elaborated and adjusted with terms (time unlimited) of published epidemiological reviews to single organs.
The broad clinical spectrum with differential diagnoses is displayed. An allocation of cutaneous metastases and a particular organ is not reliable. In 22% of all cases cutaneous metastases can lead to the diagnosis of an internal malignoma. The majority of cases reveal cutaneous metastases to emerge in a tumour-free interval in about 36 months, after a successful treatment of the primary tumour, most commonly along with other organ metastases. Probable survival turned out to be less than 12 months. Consistently with this end-stage condition, treatment aligns with rules of palliation. Local treatment of choice is excision. Only a minority of investigators attempted to come up with tumour-specific treatment strategies, and almost no randomised therapy studies can be presented.
A reference guide of cutaneous metastases is given; the clinical spectrum is adjusted to an actual status; state of the art of the treatment is accomplished. An epidemiological, improved registration and diagnostic work-up for targeted therapies in conjunction with dermatologists are favoured.
高达10%的所有内脏恶性肿瘤会发生皮肤转移。由于皮肤转移被低估且诊断不足，它们可能构成临床挑战。本文汇编了皮肤转移的临床表现、分布模式、临床结局特征及可用的治疗选择。
全面评估了过去6年关于皮肤转移的文献（医学主题词）。对92例可用病例的特征进行了阐述，并根据已发表的流行病学综述（时间不限）对单个器官的术语进行了调整。
展示了具有鉴别诊断的广泛临床谱。皮肤转移与特定器官的关联不可靠。在所有病例中，22%的皮肤转移可导致内脏恶性肿瘤的诊断。大多数病例显示，在原发性肿瘤成功治疗后约36个月的无瘤间期出现皮肤转移，最常见的是伴有其他器官转移。可能的生存期不到12个月。与此终末期情况一致，治疗遵循姑息治疗原则。局部治疗的首选是切除。只有少数研究者尝试提出肿瘤特异性治疗策略，几乎没有随机治疗研究。
给出了皮肤转移的参考指南；将临床谱调整到实际情况；完成了治疗的现状。支持开展流行病学研究、改进登记工作以及与皮肤科医生联合进行靶向治疗的诊断检查。
