title: Clinicopathologic correlation of cutaneous metastases: experience from a cancer center.
abstract: OBJECTIVE
  To analyze the clinical, histopathologic, and immunohistochemical characteristics of skin metastases.
  
  
  METHODS
  Retrospective analysis (January 1, 1990, to December 31, 2005).
  
  
  METHODS
  Comprehensive cancer center.
  
  
  METHODS
  Fifty-one patients (21 men and 30 women) with biopsy-proven skin metastases and correlative clinical data.
  
  
  METHODS
  Four dermatopathologists reviewed a random mixture of metastases and primary skin tumors. Immunohistochemical studies for 12 markers were performed on the metastases, with skin adnexal tumors as controls.
  
  
  METHODS
  Clinical characteristics of cutaneous lesions, clinical outcomes, histologic features, and immunohistochemical markers.
  
  
  RESULTS
  Eighty-six percent (43 of 50) of the patients had known stage IV cancer, and skin metastasis was the presenting sign in 12% (6 of 50). In 45% (21 of 47) of the biopsies, the lesions were not suspected of being metastases owing to unusual clinical presentations. Seventy-six percent of the patients died of disease (median survival, 5 months). On pathologic review, many metastases from adenocarcinomas were either recognized or suspected, but the primary site was not easily identified based on histologic findings alone. Metastases from small cell carcinomas and sarcomas were histologically misinterpreted as primary skin tumors. Immunohistochemical analysis using a panel including p63, B72.3, calretinin, and CK5/6 differentiated metastatic carcinoma from primary skin adnexal tumors.
  
  
  CONCLUSIONS
  Cutaneous metastases can have variable clinical appearances and can mimic benign skin lesions. They are usually seen in patients with advanced disease, but they can be the presenting lesion. Although many metastatic adenocarcinomas can be recognized based on histologic findings alone, immunohistochemical analysis is an important diagnostic adjunct in some cases.
authors.affiliation: Department of Pathology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Sariya
authors.forename: Karen
authors.initials: K
authors.lastname: Ruth
authors.forename: Rose
authors.initials: R
authors.lastname: Adams-McDonnell
authors.forename: Carrie
authors.initials: C
authors.lastname: Cusack
authors.forename: XiaoWei
authors.initials: X
authors.lastname: Xu
authors.forename: Rosalie
authors.initials: R
authors.lastname: Elenitsas
authors.forename: John
authors.initials: J
authors.lastname: Seykora
authors.forename: Terri
authors.initials: T
authors.lastname: Pasha
authors.forename: Paul
authors.initials: P
authors.lastname: Zhang
authors.forename: Marisa
authors.initials: M
authors.lastname: Baldassano
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Lessin
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D002173:Cancer Care Facilities; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000556:secondary*
chemical_list: D014408:Biomarkers, Tumor