Cutaneous metastasis of neuroendocrine carcinoma of uterine origin.
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.
Fogaça
M F
MF
Department of Pathology, New England Deaconess Hospital, Boston, Massachusetts 02115.
Fedorciw
B J
BJ
Tahan
S R
SR
Johnson
R
R
Federman
M
M
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*