A Case of Metastatic Gastric Adenocarcinoma Mimicking Preseptal Cellulitis.
Cutaneous metastasis from gastric adenocarcinoma is uncommon, and the eyelid is a rare metastatic site. Three patterns of clinical presentation of eyelid metastasis have been described: nodular, infiltrative, and ulcerated. The infiltrative pattern, also known as an inflammatory diffuse pattern or mask-like metastasis, can be easily misdiagnosed as cellulitis or contact dermatitis. Here, we report a case of gastric adenocarcinoma in a 75-year-old man who presented with a localized erythematous plaque on his eyelid that developed four months earlier. The patient had been treated with an antimicrobial agent owing to suspicion of preseptal cellulitis. Gastric adenocarcinoma metastasis was diagnosed on the basis of histopathological examination and immunophenotyping (i.e., cytoplasmic epithelial membrane antigen, cytokeratin- 7, cytokeratin-20, and carcinoembryonic antigen). For patients with malignant neoplasms, persistent skin lesions similar to cellulitis or contact dermatitis should be suspected of metastasis derived from an internal malignancy, even for very rare sites of metastasis.
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kwang Hee
KH
Won
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Mi Hye
MH
Lee
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Woo Jin
WJ
Lee
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Chong Hyun
CH
Won
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Sung Eun
SE
Chang
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jee Ho
JH
Choi
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kee Chan
KC
Moon
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Mi Woo
MW
Lee
Adenocarcinoma; Eyelids; Neoplasm metastasis; Orbital cellulitis