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We describe findings in 34 cases of lung cancer with skin large-cell carcinoma in 6, squamous cell carcinoma in 4,
metastases. In 24 men and 10 women, ages ranged from and small-cell carcinoma in 2. Skin metastases were
32 to 85 years (mean, 61 years). In five, a skin lesion was proven in 15.4 percent of autopsy cases of large-cell
the first manifestation of the underlying cancer; in an- carcinoma of the lung. Mean survival time from diag-
other four, it was found coincidentally with detection of nosis of lung cancer was 10.3 months and that from di-
the lung mass. Pathologic findings included adenocar- agnosis of skin metastasis was 4.9 months. The progno-
cinoma in 18 patients, large-cell carcinoma in 9, sis for patients having lung cancer with skin metastasis
squamous cell carcinoma in 5, and small-cell carcinoma is thus very poor. In the review of 34 patients and 25
in 2. Among 87 patients with large-cell carcinoma, 9 autopsies of lung cancer with skin metastasis, we con-
(10.3 percent) developed cutaneous metastases. A review clude that the incidence of cutaneous metastasis is high
of 510 autopsies of primary lung cancer at Keio Univer- for large-cell carcinoma and low for squamous and
sity from 1958 to 1992 showed 25 cases with skin small-cell carcinoma. (Chest 1994; 106:1448-50)
metastases (4.9 percent), adenocarcinoma in 13 cases,
Key words: lung cancer, skin metastasis
*Adeno = adenocarcinoma; Squam =squamous cell; Large= large cell; Small =small cell; RUL =right upper lobe; RLL= right lower lobe; LLL =left
lower lobe; C=chemotherapy; R=radiation; O=operation.
(21), abdomen (8), back (8), upper extremities (7), scalp (Fig 1) were resected and the patient received
face (6), and scalp (5). Uncommon locations were the chemotherapy. However, the skin lesions recurred
lower extremities (4), neck, and shoulder (1 each) . during therapy.
Twenty-two of the 34 primary lung lesions in- Mean survival from the diagnosis of lung cancer
volved the upper lobes and 12 involved the lower was 10.3 months (median, 7 months) and 4.9 months
lobes. Eighteen lesions in the upper lobes were on the (median, 3 months) from the diagnosis of skin
right; of lesions in the lower lobes, 4 were on the right metastasis. Only three patients, two of whom had no
and 8 were on the left. Nine of the 27 patients had metastastic involvement of other organs, lived more
clinically occult visceral metastatic disease at the than 1 year after appearance of the skin metastasis.
time of skin biopsy. Thirty patients had received
DISCUSSION
chemotherapy and 15 had received chest irradiation.
In eight patients, skin lesions appeared after surgical Although skin metastases of lung cancer are rare,
therapy. In case 1, multiple skin metastases on the physicians are likely to see them and should be