title: Cutaneous and subcutaneous metastases of rectal cancer.
abstract: The occurrence of cutaneous metastatic disease from colorectal cancer is uncommon and typically signifies widespread disease with poor prognosis. Colorectal metastases usually occur within the first 3 years of follow up, and the median survival of patients after the appearance of cutaneous metastatic lesions is 18 to 20 months. We describe an unusual case of a 60-year-old woman with a metachronous skin lesion as the sole site of metastatic disease, and a relatively long interval between the appearance of skin metastases and death. The woman was found to have an adenocarcinoma of the rectum, a Dukes' C lesion, extending over the entire rectal wall into the perirectal fat; five of eight regional lymph nodes showed metastases. Adjuvant radiotherapy followed by chemotherapy was administered for about 1 year. A subcutaneous lump on the left abdominal wall found 16 months postoperatively was metastatic of rectal origin. A metastatic adenocarcinoma of rectal origin was found in a single left lower axillary node 26 months later. Despite metastatic work-up for the next 2 years, an enlarged and palpated metastatic left inguinal lymph node appeared and was subjected to radiation. Computerized tomography (CT) examination 5 years after the first presentation of the rectal tumor and almost 4 years after the diagnosis of abdominal skin metastases disclosed recurrent pelvic disease with severe left hydronephrosis. Treatment by systemic chemotherapy was partially successful, but she died 8 months after this chemotherapy was initiated.
authors.affiliation: Department of Oncology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Sarid
authors.forename: Nely
authors.initials: N
authors.lastname: Wigler
authors.forename: Zeev
authors.initials: Z
authors.lastname: Gutkin
authors.forename: Ofer
authors.initials: O
authors.lastname: Merimsky
authors.forename: Leonore
authors.initials: L
authors.lastname: Leider-Trejo
authors.forename: Ilan G
authors.initials: IG
authors.lastname: Ron
mesh_terms: D034861:Abdominal Wall / Q000473:pathology; D000230:Adenocarcinoma / Q000556:secondary*; D001365:Axilla; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology*; D012878:Skin Neoplasms / Q000556:secondary*; D040521:Subcutaneous Tissue / Q000473:pathology