Department of Dermatology, The University of Texas Medical Branch, Galveston, TX.
Am J Dermatopathol. 2022 Nov 1;44(11):828-830. doi: 10.1097/DAD.0000000000002253. Epub 2022 Jul 28.
The Sister Mary Joseph nodule is a metastatic umbilical lesion that is seen in 1%-3% of intra-abdominal and pelvic malignancies. Cutaneous metastasis of visceral malignancies is rare and has characteristic dermal or subcutaneous involvement on histopathologic examination. Epidermotropism is described as the migration of malignant cells into the epidermis and is an unusual finding in intra-abdominal malignancies and cutaneous metastases. An 81-year-old woman with a past medical history of colorectal adenocarcinoma presented to the dermatology clinic for evaluation of an enlarging, denuded umbilical mass. A tangential biopsy was obtained and sent for histopathologic examination. Histopathologic analysis demonstrated infiltration of atypical, pleomorphic cells in the dermis with spread into the epidermis, consistent with epidermotropism. An immunohistochemical panel was performed and was consistent with cutaneous metastasis of the patient's underlying adenocarcinoma. We present a case of epidermotropic cutaneous metastasis of colorectal adenocarcinoma presenting as a Sister Mary Joseph nodule, an extremely rare occurrence that has not been well-documented in the literature.
圣母玛利亚·约瑟夫结节是一种转移性脐部病变，见于 1%-3%的腹腔和盆腔恶性肿瘤。内脏恶性肿瘤的皮肤转移非常罕见，在组织病理学检查时具有特征性的真皮或皮下受累。表皮亲嗜性是指恶性细胞迁移到表皮中，这在腹腔内恶性肿瘤和皮肤转移中是一种不常见的发现。一位 81 岁的女性，既往有结直肠腺癌病史，因脐部增大、裸露的肿块就诊于皮肤科。进行了切线活检，并进行了组织病理学检查。组织病理学分析显示真皮中有浸润性不典型、多形性细胞，并扩散到表皮，符合表皮亲嗜性。进行了免疫组化检测，与患者潜在腺癌的皮肤转移一致。我们报告了一例结直肠腺癌表皮亲嗜性皮肤转移，表现为圣母玛利亚·约瑟夫结节，这是一种非常罕见的情况，文献中报道较少。
