title: Inflammatory skin metastasis as a first sign of progression of lung cancer--a case report.
abstract: BACKGROUND
  Skin metastases are present in 1-9% of cancer patients. In rare cases, skin metastases can manifest as lesions with signs of inflammation and are diagnosed as inflammatory cutaneous metastases (ICM). ICM in lung cancer are extremely rare and often misdiagnosed.
  
  
  METHODS
  We report on a 55-year-old man with metastatic lung adenocarcinoma and bone metastases in the axial skeleton and left humerus diagnosed in August 2008. He underwent 6 cycles of palliative chemotherapy with cisplatin and gemcitabine, obtaining a minor response. Five months later, he experienced increasing pain in his left arm, with erythematous oedematous lesion with poorly defined margins and an inflammatory appearance. A diagnosis of skin infection was made and he was treated by antibiotic therapy without improvement.
  
  
  RESULTS
  Skin biopsy revealed skin infiltration by poorly differentiated carcinoma compatible with a primary lung tumour. He was started on second line therapy with docetaxel, however, the patient's status deteriorated rapidly and he died two months after the first appearance of ICM.
  
  
  CONCLUSIONS
  Metastasis of lung carcinoma could be one of the causes of inflammatory skin lesions in cancer patients and these metastases should be considered in cancer patients with persisting cutaneous lesions with signs of inflammation and no response to antibiotic therapy.
authors.affiliation: Department of Medical Oncology School of Medicine, Comenius University, Bratislava, Slovakia. misomego@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Mego
authors.forename: Z
authors.initials: Z
authors.lastname: Sycova-Mila
authors.forename: P
authors.initials: P
authors.lastname: Martanovic
authors.forename: S
authors.initials: S
authors.lastname: Liskova
authors.forename: J
authors.initials: J
authors.lastname: Obertova
authors.forename: J
authors.initials: J
authors.lastname: Mardiak
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary*; D001859:Bone Neoplasms / Q000556:secondary; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology / Q000556:secondary*