Multiple nodules on the face and trunk in metastatic adenocarcinoma of unknown primary origin

Furtado S, Bhat RM, Sukumar D, Krishnamurthy SG, Rao SD, Nandakishore B
Correspondence: Dr Shireen Furtado, shireenseq@gmail.com

ABSTRACT
Metastatic cancer of unknown primary (CUP) may unexpectedly manifest on the skin and subcutaneous tissue, prompting the patient to first visit a dermatologist. We describe an interesting case of cutaneous metastases from poorly differentiated adenocarcinoma of an unknown primary site in a 57-year-old man. The CUP had an unusually long period of indolence between presentation as a solitary axillary lymph node metastasis and rapid cutaneous dissemination. The possible causes of such a presentation are reviewed, and the management is briefly discussed. Diagnosis of unusual cutaneous manifestations of occult systemic malignancies could pose a diagnostic challenge to dermatologists.

Keywords: axilla, carcinoma, cutaneous metastasis, chemotherapy, tumour marker
Singapore Med J 2011; 52(7): e163-e166