Cutaneous metastases of visceral tumours: a review.
BACKGROUND
Up to 10% of all visceral malignancies develop cutaneous metastases. As cutaneous metastases are underestimated and underdiagnosed they can be a clinical challenge. The clinical appearance and patterns of distribution of cutaneous metastases, the characterisation of clinical outcomes and available therapeutic options are compiled.


METHODS
Literature (over the last 6 years) MESH in terms of cutaneous metastases was comprehensively evaluated. Characteristics from 92 available cases are elaborated and adjusted with terms (time unlimited) of published epidemiological reviews to single organs.


RESULTS
The broad clinical spectrum with differential diagnoses is displayed. An allocation of cutaneous metastases and a particular organ is not reliable. In 22% of all cases cutaneous metastases can lead to the diagnosis of an internal malignoma. The majority of cases reveal cutaneous metastases to emerge in a tumour-free interval in about 36 months, after a successful treatment of the primary tumour, most commonly along with other organ metastases. Probable survival turned out to be less than 12 months. Consistently with this end-stage condition, treatment aligns with rules of palliation. Local treatment of choice is excision. Only a minority of investigators attempted to come up with tumour-specific treatment strategies, and almost no randomised therapy studies can be presented.


CONCLUSIONS
A reference guide of cutaneous metastases is given; the clinical spectrum is adjusted to an actual status; state of the art of the treatment is accomplished. An epidemiological, improved registration and diagnostic work-up for targeted therapies in conjunction with dermatologists are favoured.
Nashan
Dorothée
D
Department of Dermatology, University Medical Center Freiburg, Hauptstr. 7, 79104, Freiburg, Germany. dorothee.nashan@uniklinik-freiburg.de
Müller
Marcel Lucas
ML
Braun-Falco
Markus
M
Reichenberger
Sebastian
S
Szeimies
Rolf-Markus
RM
Bruckner-Tuderman
Leena
L
D001943:Breast Neoplasms / Q000473:pathology; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology; D006258:Head and Neck Neoplasms / Q000473:pathology; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology; D009369:Neoplasms / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000473:pathology; D012878:Skin Neoplasms / Q000556:secondary*; D014781:Viscera / Q000473:pathology*