Thurston D, Hossain T, Waraich N, Shukla A
United Lincolnshire Hospitals NHS Trust , UK.
Ann R Coll Surg Engl. 2016 Mar;98(3):e47-8. doi: 10.1308/rcsann.2016.0088.
Cutaneous manifestations of visceral carcinomas are scarce, occurring in around 0.7-12% of internal malignancies. Lung cancer is one of the most common sources of skin metastasis, particularly in male patients. We present a case of cutaneous metastasis in a man with concurrent lung lesions and a previously treated colorectal carcinoma. Immunohistochemistry markers for both skin and lung lesions were strongly positive for carcinoembryonic antigen and cytokeratin 20, suggesting an intestinal primary tumour. However, colonoscopy excluded new and metastatic bowel lesions. After multidisciplinary team meetings, which reviewed the clinical, radiological and immunohistochemistry findings, it was concluded to be a non-small cell lung cancer with skin metastasis. This case presented an interesting diagnostic challenge, and highlighted the importance of cross-specialty liaison and investigation to reach the correct diagnosis.
内脏癌的皮肤表现较为罕见，约占所有内部恶性肿瘤的0.7 - 12%。肺癌是皮肤转移最常见的来源之一，尤其在男性患者中。我们报告一例男性患者，其同时存在肺部病变且既往有结直肠癌病史，现出现皮肤转移。皮肤和肺部病变的免疫组化标志物癌胚抗原和细胞角蛋白20均呈强阳性，提示原发性肠道肿瘤。然而，结肠镜检查排除了新的及转移性肠道病变。经过多学科团队会议，综合回顾临床、影像学及免疫组化结果后，诊断为非小细胞肺癌伴皮肤转移。该病例带来了有趣的诊断挑战，并凸显了跨专业协作及检查对于正确诊断的重要性。
