Pathak Smita, Joshi Sneha R, Jaison Janice, Kendre Dipak
Department of Pathology, Maharashtra Institute of Medical Education and Research (MIMER) Medical College, Talegaon Dabhade. Pune, Maharashtra, India.
Indian Dermatol Online J. 2013 Jul;4(3):185-7. doi: 10.4103/2229-5178.115512.
A 65-year-old male with a history of smoking since 30 years presented with breathlessness, hemoptysis, multiple swellings all over the body, and weakness in September 2010 at our hospital. Clinically, a diagnosis of chronic obstructive pulmonary disease (COPD) with cutaneous lymphoma or soft tissue tumor was made. Chest X-ray (CXR) and computed tomography (CT) scan revealed a neoplastic lesion in the right lung with secondary cavitation. Biopsy of the cutaneous nodules showed metastatic deposits from squamous cell carcinoma. Metastatic skin cancer is a relatively rare complication of internal malignancy. The clinical features of metastatic skin disease vary enormously. They may present as erysipeloid, sclerodermoid, alopecia neoplastica or in an inflammatory or bullous form or as multiple nodules as in our case. A high index of suspicion for metastatic deposits is required in an elderly male patient who is a known case of lung cancer or even one who is a chronic smoker and presents with such cutaneous lesions.
一名65岁男性，有30年吸烟史，于2010年9月因呼吸困难、咯血、全身多处肿胀及乏力到我院就诊。临床上，诊断为慢性阻塞性肺疾病（COPD）合并皮肤淋巴瘤或软组织肿瘤。胸部X线（CXR）和计算机断层扫描（CT）显示右肺有一个肿瘤性病变并伴有继发性空洞形成。皮肤结节活检显示为鳞状细胞癌转移灶。转移性皮肤癌是内脏恶性肿瘤相对罕见的并发症。转移性皮肤病的临床特征差异极大。它们可能表现为丹毒样、硬皮病样、肿瘤性脱发，或以炎症或大疱形式出现，或如我们的病例那样表现为多个结节。对于已知患有肺癌的老年男性患者，甚至是慢性吸烟者且出现此类皮肤病变的患者，都需要高度怀疑有转移灶。
