Cutaneous Metastases Flashcards
What are the most common cutaneous metastases in women and men?
women: breast and melanoma
men: melanoma, head & neck, lung, colon
What is the most common clinical presentation of cutaneous metastases?
Firm, painless, erythematous nodule(s)
What are the most common cancers on the scalp in men and women?
Most common metastases on the abdomen in men and women?
Men: Colon, lung, stomach
Woman: Colon, ovary, breast
What are the most common tumors that the Sister Mary Joseph nodule represent?
Gastric cancer, colon, ovarian, or pancreatic cancers
What can be the different cutaneous presentations of cutaneous metastases from breast cancer?
Papulonodules, patches of erythema, woody induration w/ peau d’ orange
What is the most common presentation of cutaneous metastasis?
Dermal or subcutaneous nodules (can be miliary in size or large, multiple or small)
What is the histology of dermal or subcutaneous cutaneous metastases?
Tumor cells infiltrating among collagen bundles or replacing dermis; grenz zone often present
What is the presentation of inflammatory carcinoma (carcinoma erysipeloides)?
Erythematous patch with spreading border; resembles erysipelas
What cancers are most often represented by inflammatory carcinoma (carcinoma erysipeloides)?
Breast>> lung, ovary, prostate, GI, others
What is the histology of inflammatory carcinoma (carcinoma erysipeloides)?
Tumor cells in dilated lymphatic vessels
What is cutaneous metastasis en cuirasse?
Morpheaform or sclerodermoid, depending upon extent can be indurated with peau d’orange appearance
What cancers are represented by cutaneous metastasis en cuirasse?
Breast>>lung, GI, kindey, others
What is the histology of cutaneous metastasis en cuirasse?
Fibrosis with infiltrating tumor cells
What is the clinical appearance of carcinoma telangiectodes?
What cancer is usually represented by carcinoma telangiectodes?
Breast
What is the histology of carcinoma telangiectodes?
Tumor cells within superficial blood vessels and RBC sludging
What is the clinical appearance of Paget’s disease of the breast?
What is the histology of Paget’s disease of the breast?
large, atypical epithelial cells with abundant pale cytoplasm arranged in solitary units and small nests within all layers of the epidermis
What is the clinical appearance of alopecia neoplastica?
Nodules or plaques on the scalp in association with alopecia
What is the clinical appearance of alopecia neoplastica?
Cords of tumor cells between collagen bundles
What tumors are represented by alopecia neoplastica?
What is the clinical of pyogenic granuloma-like cutaneous metastasis?
Rapidly growing nodule resembling a vascular tumor (particular a pyogenic granuloma)
What is the histology of pyogenic granuloma-like cutaneous metastasis?
Neoplastic cells in cords and lobules admixed with prominent hemorrhage and “pseudovascular” spaces
What tumors are most often involved in pyogenic granuloma-like cutaneous metastasis?
Renal clear cell carcinoma, hepatocellular carcinoma > others
What stains are important for renal cell cutaneous carcinomas?
CD10, PAX-8
What is one key IHC stain for colon cancer?
Histology of cutaneous metastasis for thyroid cancer?
What important stains should be done initially for a cutaneous metastasis?
CD45/CD43 (hematopoietic lineage), CD34/podoplanin/CD31 (Vascular neoplasms), S100/MITF/HMB45/SOX-10/Melan-A (Melanoma),
Keratins, if + –> C5/6, p40/p64 if + –> CK7 –> if + then CK20 (distinguishes bladder/urothelial if + or breast/lung/ovarian/endometrial/pancreas if -. If CK7 is negative –> CK20 still –> if + colorectal/gastric and if negative = prostate/renal
