Case Reports in Oncology (Jun 2019)

Lung Cancer Presenting as Skin Metastasis of the Back and Hand: A Case Series and Literature Review

  • Misbahuddin Khaja,
  • Daniel Mundt,
  • Rizwan Ahmed Dudekula,
  • Umair Ashraf,
  • Shehriyar Mehershahi,
  • Masooma Niazi,
  • Dimitry Lvovsky,
  • Sandeep Malik,
  • Gilda Diaz-Fuentes

DOI
https://doi.org/10.1159/000501363
Journal volume & issue
Vol. 12, no. 2
pp. 480 – 487

Abstract

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Lung cancer has the highest mortality of all cancers in the United States. The incidence of lung cancer with metastases to the skin varies between 1–12%, with the highest incidence seen in men. Here, we present two cases of lung cancer presenting as skin metastasis. The first patient was an 80-year-old African American male who presented to the hospital for evaluation of a right upper back mass. A few months prior to admission, he was found to have a left lung mass on CT scan of the chest, he underwent biopsy which showed poorly differentiated SCC of the lung. He also had a skin biopsy which showed poorly differentiated carcinoma in the dermis consistent with metastatic SCC. He was started on chemotherapy, but could not tolerate it. He was accepted to hospice. The second patient was a 78-year-old Hispanic female who presented to the hospital with dyspnea, and a dry cough. Upon physical examination, a 2 × 2 cm ulcerated, wart-like nodule on the right palm was noted. Subsequent CT scan of the chest showed a partial collapse of the right middle lobe. A biopsy of the hand mass revealed well-to-moderately differentiated metastatic SCC favoring lung origin. A bronchoscopy biopsy showed invasive SCC. Subsequently her condition worsened and she passed away. Metastasis to the skin is an unusual presenting symptom of lung cancer. It is therefore essential to consider metastasis as a diagnosis in a patient with both a skin lesion and a smoking history.

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