title: Skin metastases from lung cancer: a case report.
abstract: BACKGROUND
  Lung cancer is one of the most frequent malignancies, with high mortality rates. It can metastasize in almost all organs, but more often invades hilar nodes, liver, adrenal glands, bones and brain. There are various data on the incidence of lung cancer metastases in the skin. In 1-12% of patients with lung cancer are developed skin metastases. Metastases in the skin may be the first sign of lung cancer.
  
  
  METHODS
  Forty-five years old Albanian male, smoker, was admitted to our department with multiple nodules localized in the skin of the head, neck, back and chest. The nodules measuring 5-15 millimeters in greatest dimension were round and skin-colored, with telangiectasias, firm and tender. They appeared in an eruptive form about two weeks before being admitted at our hospital. In addition, the patient exhibited signs of weight loss, anorexia and fatigue. Excisional biopsy was performed to one of the lesions. Histopathology confirmed metastatic nature of the lesion namely, malignant tumor of neuroendocrine phenotype consistent with small-cell carcinoma. Chest X-ray and computed tomography revealed an expansive process in the 7(th) segment of the left lung, left hilar and mediastinal lymphadenopathy and a suspicious initial secondary deposit in the left adrenal gland. The patient was referred to the department of oncology for further treatment. After the third cycle of chemotherapy, the magnetic resonance imaging revealed brain metastases. The patient passed away four months after the diagnosis of lung cancer first presented with skin metastases.
  
  
  CONCLUSIONS
  Metastases in skin may be the first sign of lung cancer. Although rare appearing, we should raise suspicion in cases of atypical lesions in the skin not only of the smokers, but also of the non-smokers. Skin metastases from small-cell lung carcinoma are a poor prognostic indicator. The appearance of multiple skin metastases with other internal metastases shorten the survival time.
authors.affiliation: Department of Dermatology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo. laurapajaziti@gmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Pajaziti
authors.affiliation: Department of Dermatology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo. syzana.rexhepi@hotmail.com.
authors.forename: Syzana Rexhepi
authors.initials: SR
authors.lastname: Hapçiu
authors.affiliation: Department of Dermatology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo. shkendijad@gmail.com.
authors.forename: Shkendije
authors.initials: S
authors.lastname: Dobruna
authors.affiliation: Department of Radiology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo. naimhoxha@gmail.com.
authors.forename: Naim
authors.initials: N
authors.lastname: Hoxha
authors.affiliation: Institute of Pathology, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo. fisnik.kurshumliu@uni-pr.edu.
authors.forename: Fisnik
authors.initials: F
authors.lastname: Kurshumliu
authors.affiliation: Faculty of Medicine, University Clinical Centre of Kosovo, Prishtina, Republic of Kosovo. artina.pajaziti@hotmail.com.
authors.forename: Artina
authors.initials: A
authors.lastname: Pajaziti
mesh_terms: D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary*; D017809:Fatal Outcome; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000556:secondary*; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000556:secondary*; D015431:Weight Loss