Upper limb amputation in the course of skin metastases of rectal cancer

Abstract

Skin metastases occur in 4% patients with metastatic colorectal cancer. They are interpretated as unfavourable prognostic factor. as accompanying multi-organ metastases which are more often the death cause. The authors are presenting the case of 82 years old patient qualified to pallitive chemotherapy with fluorouracyl and leucovorin due to rectal cancer metasteses to bones, lungs, and hand and lower arm skin in 4 years after radical therapy of focus primarius . The patient underwent palliative radiotherapy of bone metatstases to left arm. After first course of chemotherapy the bleeding from the skin metastases stopped and the necrosis increased. After the second chemotherapy course, the left arm amputation was done due to massive bleeding from the skin lesion. After confirming CNS metastases the brain was irradiated palliatively and the systemic therapy was finished.
Skin metastases rarely can lead to severe clinical complications (eg. death) but because of potential infections and bleeding can decrease the patients´ quality of life. Therefore not only high qualified therpay of cancer is needed but adequate symptoms managemnet as well.