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Published online: 2024-11-19

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Carcinoma lung with cutaneous metastasis: experience from an Indian institute

Diptajit Paul1, Sheeba Bhardwaj1, Abhishek Soni1, Ashok Chauhan1, Rakesh Dhankhar1, Paramjeet Kaur1

Abstract

Background: Majority of lung cancer patients are presented with metastatic disease. However, cutaneous metastasis (CM) from lung carcinoma is a rare entity with very few case reports published in the Indian background. Moreover, outcome in these patients is dismal and no standard therapeutic approaches are there. Thus, a long-term analysis from a single institute in this infrequent occurrence holds scientific importance. The purpose of this study was to describe the clinico-demographic profile of patients having CM with lung primary and also to evaluate the survival outcomes in these patients.

Materials and methods: This was a retro-prospective study conducted over 5-year time period in an academic institute of India. Records of all histopathologically confirmed lung cancer patients were reviewed and patients having biopsy-proven CM were included in this analysis. Permission from Institutional Ethics Committee and informed consent from all the patients were taken. Data of these patients were collected and analysed using standard statistical software.

Results: Total of 25 cases of biopsy-proven CM were found in the stipulated time period. Mean age of patients was 57.6 years with high male predominance. Anterior chest wall was the most common site of skin involvement and squamous cell carcinoma was the most common primary histopathology. Overall, median survival was 4.9 months.

Conclusion: Once CM developed, survival of lung carcinoma patients become dismal. Goal of the treatment will be to palliate and to improve quality of life in these patients. Understanding the clinical pattern and demographic profile of these patients will guide a standard treatment approach.

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References

  1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3): 209–249.
  2. Noronha V, Pinninti R, Patil VM, et al. Lung cancer in the Indian subcontinent. South Asian J Cancer. 2016; 5(3): 95–103.
  3. Zappa C, Mousa SA. Non-small cell lung cancer: current treatment and future advances. Transl Lung Cancer Res. 2016; 5(3): 288–300.
  4. Niu FY, Zhou Q, Yang JJ, et al. Distribution and prognosis of uncommon metastases from non-small cell lung cancer. BMC Cancer. 2016; 16: 149.
  5. Milovanovic IS, Stjepanovic M, Mitrovic D. Distribution patterns of the metastases of the lung carcinoma in relation to histological type of the primary tumor: An autopsy study. Ann Thorac Med. 2017; 12(3): 191–198.
  6. Ganguly S, Ghosh J, Gehani A, et al. Non-small-cell lung cancer metastasis to unusual sites. Cancer Res Stat Treat. 2021; 4(1): 50–54.
  7. Ruiz SJ, Al Salihi S, Prieto VG, et al. Unusual cutaneous metastatic carcinoma. Ann Diagn Pathol. 2019; 43: 151399.
  8. Hussein MR. Skin metastasis: a pathologist's perspective. J Cutan Pathol. 2010; 37(9): e1–20.
  9. Handa U, Kundu R, Dimri K. Cutaneous Metastasis: A Study of 138 Cases Diagnosed by Fine-Needle Aspiration Cytology. Acta Cytol. 2017; 61(1): 47–54.
  10. Sariya D, Ruth K, Adams-McDonnell R, et al. Clinicopathologic correlation of cutaneous metastases: experience from a cancer center. Arch Dermatol. 2007; 143(5): 613–620.
  11. Teyateeti P, Ungtrakul T. Retrospective review of cutaneous metastasis among 11,418 patients with solid malignancy: A tertiary cancer center experience. Medicine (Baltimore). 2021; 100(29): e26737.
  12. Mollet TW, Garcia CA, Koester G. Skin metastases from lung cancer. Dermatol Online J. 2009; 15(5): 1.
  13. Song C, Yu D, Wang Y, et al. Dual Primary Cancer Patients With Lung Cancer as a Second Primary Malignancy: A Population-Based Study. Front Oncol. 2020; 10: 515606.
  14. Marcoval J, Penín RM, Llatjós R, et al. Cutaneous metastasis from lung cancer: retrospective analysis of 30 patients. Australas J Dermatol. 2012; 53(4): 288–290.
  15. Beachkofsky TM, Wisco OJ, Osswald SS, et al. Pulmonary cutaneous metastasis: a case report and review of common cutaneous metastases. Cutis. 2009; 84(6): 315–322.
  16. Sakhri S, Zemni I, Ayadi MA, et al. Cutaneous metastasis as a first presentation of lung carcinoma: a case series. J Med Case Rep. 2023; 17(1): 315.
  17. Perng DW, Chen CH, Lee YC, et al. Cutaneous metastasis of lung cancer: an ominous prognostic sign. Zhonghua Yi Xue Za Zhi (Taipei). 1996; 57(5): 343–347.
  18. Chun SM, Kim YC, Lee JB, et al. Nasal tip cutaneous metastases secondary to lung carcinoma: three case reports and a review of the literature. Acta Derm Venereol. 2013; 93(5): 569–572.
  19. Ardavanis A, Orphanos G, Ioannidis G, et al. Skin metastases from primary lung cancer. Report of three cases and a brief review. In Vivo. 2006; 20(5): 671–673.
  20. Lu S, Yang J, Sun Y, et al. Multiple cutaneous and intestinal metastases in lung cancer: A case report. Oncol Lett. 2015; 9(4): 1541–1544.
  21. Molina Garrido MJ, Guillén Ponce C, Soto Martínez JL, et al. Cutaneous metastases of lung cancer. Clin Transl Oncol. 2006; 8(5): 330–333.
  22. Song Z, Lin B, Shao L, et al. Cutaneous metastasis as a initial presentation in advanced non-small cell lung cancer and its poor survival prognosis. J Cancer Res Clin Oncol. 2012; 138(10): 1613–1617.
  23. Bhattarai B, Schmidt MF, Ghosh M, et al. Lung cancer with skin and breast metastasis: a case report and literature review. Case Rep Pulmonol. 2015; 2015: 136970.
  24. Ambrogi V, Nofroni I, Tonini G, et al. Skin metastases in lung cancer: analysis of a 10-year experience. Oncol Rep. 2001; 8(1): 57–61.
  25. Betlloch-Mas I, Soriano-García T, Boira I, et al. Cutaneous Metastases of Solid Tumors: Demographic, Clinical, and Survival Characteristics. Cureus. 2021; 13(11): e19970.
  26. Barbetakis N, Samanidis G, Paliouras D, et al. Facial skin metastasis due to small-cell lung cancer: a case report. J Med Case Rep. 2009; 3: 32.
  27. Mego M, Sycova-Mila Z, Martanovic P, et al. Inflammatory skin metastasis as a first sign of progression of lung cancer--a case report. Klin Onkol. 2010; 23(6): 449–451.
  28. Pathak S, Joshi SR, Jaison J, et al. Cutaneous metastasis from carcinoma of lung. Indian Dermatol Online J. 2013; 4(3): 185–187.
  29. Fratus G, Tagliabue F, Mariani P, et al. Cutaneous metastasis from lung cancer. Case report. Ann Ital Chir. 2014; 85(ePub).
  30. Elfatoiki FZ, Hali F. Cutaneous metastasis reveling lung cancer. Pan Afr Med J. 2015; 20: 19.
  31. Pajaziti L, Hapçiu SR, Dobruna S, et al. Skin metastases from lung cancer: a case report. BMC Res Notes. 2015; 8: 139.
  32. Scott GD, Kwong BY, Novoa RA. Epidermotropic metastasis of primary lung adenocarcinoma. J Cutan Pathol. 2016; 43(9): 798–801.
  33. Khaja M, Mundt D, Dudekula RA, et al. Lung Cancer Presenting as Skin Metastasis of the Back and Hand: A Case Series and Literature Review. Case Rep Oncol. 2019; 12(2): 480–487.
  34. Yasokawa N, Yasuda Y, Chin H, et al. Generalized herpes zoster and cutaneous metastasis during chemotherapy for non-small cell lung cancer: A case report. Thorac Cancer. 2021; 12(1): 117–121.
  35. Wang X, Wang H, Jia B, et al. Cutaneous Metastasis as the First Presentation of Non-Small-Cell Lung Cancer with a BRAF Mutation: A Case Report. Onco Targets Ther. 2020; 13: 13143–13149.
  36. Gogia P, Wallach J, Dhull AK, et al. Multiple cutaneous and haemorrhagic brain metastases as the sentinel presentation of lung adenocarcinoma. BMJ Case Rep. 2020; 13(11).
  37. Sharma G, Kumar P, Veerwal H, et al. Cutaneous Metastases as Initial Presentation of Lung Carcinoma. Cureus. 2021; 13(5): e15344.
  38. Vouchara A, Karlafti E, Intzidis IT, et al. Cutaneous Lesions: An Unusual Clinical Presentation of Small Cell Lung Cancer. Am J Case Rep. 2022; 23: e935313.
  39. Zhong L, Mao D, Li H, et al. Cutaneous Metastasis from Lung Adenocarcinoma. Clin Cosmet Investig Dermatol. 2022; 15: 1869–1872.
  40. 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.
  41. Kaur H, Sehgal IS, Bal A, et al. Evolving epidemiology of lung cancer in India: Reducing non-small cell lung cancer-not otherwise specified and quantifying tobacco smoke exposure are the key. Indian J Cancer. 2017; 54(1): 285–290.
  42. Suliankatchi Abdulkader R, Sinha DN, Jeyashree K, et al. Trends in tobacco consumption in India 1987-2016: impact of the World Health Organization Framework Convention on Tobacco Control. Int J Public Health. 2019; 64(6): 841–851.
  43. Shamji FM, Beauchamp G, Sekhon HJ. The Lymphatic Spread of Lung Cancer: An Investigation of the Anatomy of the Lymphatic Drainage of the Lungs and Preoperative Mediastinal Staging. Thorac Surg Clin. 2021; 31(4): 429–440.
  44. Vadnal KT, Triller N, Pozek I, et al. Skin metastases of lung cancer. Acta Dermatovenerol Alp Pannonica Adriat. 2008; 17(3): 125–128.
  45. Dey A, Biswas D, Saha SK, et al. Comparison study of clinicoradiological profile of primary lung cancer cases: an Eastern India experience. Indian J Cancer. 2012; 49(1): 89–95.
  46. Babacan NA, Kiliçkap S, Sene S, et al. A Case of Multifocal Skin Metastases from Lung Cancer Presenting with Vasculitic-type Cutaneous Nodule. Indian J Dermatol. 2015; 60(2): 213.
  47. Janopaul-Naylor JR, Shen Y, Qian DC, et al. The Abscopal Effect: A Review of Pre-Clinical and Clinical Advances. Int J Mol Sci. 2021; 22(20).
  48. Abuodeh Y, Venkat P, Kim S. Systematic review of case reports on the abscopal effect. Curr Probl Cancer. 2016; 40(1): 25–37.
  49. Garelli E, Rittmeyer A, Putora PM, et al. Abscopal effect in lung cancer: three case reports and a concise review. Immunotherapy. 2019; 11(17): 1445–1461.
  50. Ollivier L, Orione C, Bore P, et al. Abscopal Response in Metastatic Melanoma: Real-World Data of a Retrospective, Multicenter Study. Cancers (Basel). 2022; 14(17).