open access

Vol 89, No 2 (2021)
Clinical vignette
Submitted: 2020-08-08
Accepted: 2020-10-17
Published online: 2021-02-03
Get Citation

Not just skin deep: Multiple cutaneous nodules as first presenting sign of small cell cancer

Avneet Garg1, Harshi Dhingra1, Vinita Jindal1, Mansimranjit Kaur1, Vijay Suri1
DOI: 10.5603/ARM.a2020.0192
·
Pubmed: 33559120
·
Adv Respir Med 2021;89(2):221-222.
Affiliations
  1. Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India

open access

Vol 89, No 2 (2021)
CLINICAL VIGNETTES
Submitted: 2020-08-08
Accepted: 2020-10-17
Published online: 2021-02-03

Abstract

A 65 years old male, chronic smoker (30 pack years), presented with complaints of dyspnea (mMRC grade2), cough (dry in nature), loss of appetite, loss of weight ( > 5 kgs), weakness, bony pains, feverish feeling and easy fatigability for last 2–3 months.Contrast enhanced CT chest showed bilateral extensive paraseptal and centriacinar emphysematous changes, right upper lobe spiculated heterogeneously enhancing soft tissue lesion and significant conglomerate mediastinal lymphadenopathy encasing lower trachea and great vessels.As patient was high risk for development of pneumothorax related to image guided sampling of right upper lobe lesion in view of extensive emphysema; patient was referred to us for EBUS-TBNA (endobronchial ultrasound guided transbronchial needle aspiration) guided mediastinal lymph nodes sampling. But on head to toe examination revealed round, firm, non-tender, skin coloured, 2–3 cm size skin nodules (2 on left lateral chest wall, 1 on right lateral chest wall and 1 in proximity to umbilicus).Fine needle aspiration cytology (FNAC) was attempted from two of skin nodules which was suggestive of small cell lung cancerSkin metastasis as initial presentation is reported rarely in small cell lung cancer.The index case emphasize on importance of detailed physical examination in cases of lung cancer to look for any skin manifestation of the disease, although encountered rarely.Moreover detection of skin nodules helps in staging and prognosis of diseases.

Abstract

A 65 years old male, chronic smoker (30 pack years), presented with complaints of dyspnea (mMRC grade2), cough (dry in nature), loss of appetite, loss of weight ( > 5 kgs), weakness, bony pains, feverish feeling and easy fatigability for last 2–3 months.Contrast enhanced CT chest showed bilateral extensive paraseptal and centriacinar emphysematous changes, right upper lobe spiculated heterogeneously enhancing soft tissue lesion and significant conglomerate mediastinal lymphadenopathy encasing lower trachea and great vessels.As patient was high risk for development of pneumothorax related to image guided sampling of right upper lobe lesion in view of extensive emphysema; patient was referred to us for EBUS-TBNA (endobronchial ultrasound guided transbronchial needle aspiration) guided mediastinal lymph nodes sampling. But on head to toe examination revealed round, firm, non-tender, skin coloured, 2–3 cm size skin nodules (2 on left lateral chest wall, 1 on right lateral chest wall and 1 in proximity to umbilicus).Fine needle aspiration cytology (FNAC) was attempted from two of skin nodules which was suggestive of small cell lung cancerSkin metastasis as initial presentation is reported rarely in small cell lung cancer.The index case emphasize on importance of detailed physical examination in cases of lung cancer to look for any skin manifestation of the disease, although encountered rarely.Moreover detection of skin nodules helps in staging and prognosis of diseases.

Get Citation

Keywords

cutaneous metastasis; small cell lung cancer; physical examination

About this article
Title

Not just skin deep: Multiple cutaneous nodules as first presenting sign of small cell cancer

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 2 (2021)

Article type

Clinical vignette

Pages

221-222

Published online

2021-02-03

DOI

10.5603/ARM.a2020.0192

Pubmed

33559120

Bibliographic record

Adv Respir Med 2021;89(2):221-222.

Keywords

cutaneous metastasis
small cell lung cancer
physical examination

Authors

Avneet Garg
Harshi Dhingra
Vinita Jindal
Mansimranjit Kaur
Vijay Suri

References (5)
  1. Mohan A, Garg A, Gupta A, et al. Clinical profile of lung cancer in North India: A 10-year analysis of 1862 patients from a tertiary care center. Lung India. 2020; 37(3): 190–197.
  2. Dhambri S, Zendah I, Ayadi-Kaddour A, et al. Cutaneous metastasis of lung carcinoma: a retrospective study of 12 cases. J Eur Acad Dermatol Venereol. 2011; 25(6): 722–726.
  3. Coslett LM, Katlic MR. Lung cancer with skin metastasis. Chest. 1990; 97(3): 757–759.
  4. Terashima T, Kanazawa M. Lung cancer with skin metastasis. Chest. 1994; 106(5): 1448–1450.
  5. Hidaka T, Ishii Y, Kitamura S. Clinical features of skin metastasis from lung cancer. Intern Med Tokyo Jpn. 1996; 35(6): 459–462.

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