Rahman Samia, Grewal Parbeer
Department of Medicine, University of Alberta, Edmonton, AB, Canada.
SAGE Open Med Case Rep. 2024 Dec 20;12:2050313X241309093. doi: 10.1177/2050313X241309093. eCollection 2024.
Cutaneous metastases from colorectal cancer are an uncommon but critical finding, typically signaling advanced disease with poor prognosis. This case report describes a 64-year-old woman with a limited past medical history who presented to our outpatient dermatology practice with rapidly spreading erythematous, indurated, and nearly verruciform plaques in the groin, vaginal, and perineal region. Biopsy confirmed metastatic adenocarcinoma of colonic origin, and diagnostic imaging, and colonoscopy revealed stage IV colorectal cancer involving extensive cutaneous, lymphatic, and visceral metastases. Unfortunately, the patient had not received routine colorectal cancer screening, despite a positive family history. Due to extensive disease, palliative radiation was not an option, and systemic chemotherapy was initiated. This case emphasizes the need for awareness of cutaneous metastases as a potential initial presentation of undiagnosed malignancies, the importance of routine colorectal cancer screening, and timely biopsy of suspicious skin lesions for early diagnosis and management.
结直肠癌的皮肤转移是一种罕见但关键的发现，通常预示着疾病进展且预后不良。本病例报告描述了一名64岁女性，既往病史有限，因腹股沟、阴道和会阴区域迅速扩散的红斑、硬结且近乎疣状的斑块前来我们的皮肤科门诊就诊。活检证实为结肠源性转移性腺癌，诊断性影像学检查和结肠镜检查显示为IV期结直肠癌，伴有广泛的皮肤、淋巴和内脏转移。不幸的是，尽管有家族史阳性，但该患者未接受常规的结直肠癌筛查。由于疾病广泛，姑息性放疗不可行，遂开始全身化疗。本病例强调了认识到皮肤转移可能是未诊断恶性肿瘤的潜在初始表现的必要性、常规结直肠癌筛查的重要性，以及对可疑皮肤病变进行及时活检以早期诊断和管理的重要性。
