title: Cutaneous metastasis of neuroendocrine carcinoma of uterine origin.
abstract: We report a case of a 33-year-old woman who presented with the rapid development of multiple dermal and subcutaneous nodules on the chest, back, abdomen, axilla, neck, and scalp. These nodules were firm, tender, and non-ulcerated and measured from 0.2 to 1.2 cm in diameter. A punch biopsy of one of the subcutaneous nodules in the scalp showed a poorly differentiated carcinoma in the reticular dermis with light microscopic, immunohistochemical, and ultrastructural features supporting neuroendocrine differentiation. The past medical history was significant for a recent total abdominal hysterectomy for carcinoma of the cervix at another hospital, originally characterized as a poorly differentiated adenocarcinoma of the cervix and lower uterine segment. Review of the microscopic slides of the uterine neoplasm revealed features suggesting a more appropriate classification as a primary neuroendocrine carcinoma; this was subsequently confirmed by immunophenotyping and ultrastructural evaluation. This is the first reported case of a uterine neuroendocrine carcinoma metastasizing exclusively to the skin. It further illustrates the important contribution of dermatopathology to the understanding of a systemic pathologic process.
authors.affiliation: Department of Pathology, New England Deaconess Hospital, Boston, Massachusetts 02115.
authors.forename: M F
authors.initials: MF
authors.lastname: Fogaça
authors.forename: B J
authors.initials: BJ
authors.lastname: Fedorciw
authors.forename: S R
authors.initials: SR
authors.lastname: Tahan
authors.forename: R
authors.initials: R
authors.lastname: Johnson
authors.forename: M
authors.initials: M
authors.lastname: Federman
mesh_terms: D000328:Adult; D001706:Biopsy; D018278:Carcinoma, Neuroendocrine / Q000378:metabolism / Q000473:pathology / Q000556:secondary*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008854:Microscopy, Electron; D012535:Scalp / Q000473:pathology; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology / Q000556:secondary*; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D014594:Uterine Neoplasms / Q000473:pathology*