Cutaneous Metastasis as a First Presentation for Lung Adenocarcinoma.
BACKGROUND
According to the recent World Health Organization reports, lung cancer has become the most common type of malignancy and the leading cause of death from cancer. Lung cancer frequently metastasizes to hilar lymphnodes, brain, adrenal glands, bone, but rarely to skin.


METHODS
We report a case of a 72-year-old male with a past medical history of pulmonary fibrosis and no prior history of smoking who presented to the emergency room for progressive dyspnea over three weeks. The patient reported having a rapidly growing scalp lesion as well. A computed tomography (CT) scan of the chest showed diffuse fibrotic changes and multiple densities of different diameters; a CT guided biopsy of lung revealed a poorly differentiated adenocarcinoma. Excision of right scalp lesion was performed, and pathology revealed poorly differentiated malignant neoplasm favoring adenocarcinoma.


CONCLUSIONS
We are presenting a rare case of lung adenocarcinoma presenting with skin metastasis, which was simultaneously diagnosed during the same hospitalization. Although cutaneous metastasis from the lung is rare, it must be ruled out in patients with suspicious skin lesions, smoking history, or lung cancer.
Department of Pulmonary Medicine, Saint Michael's Medical Center, Newark, New Jersey, USA.
Yazan
Y
Abdeen
Department of Internal Medicine, Saint Michael's Medical Center, Newark, New Jersey, USA.
Sawsan
S
Amireh
Department of Internal Medicine, Saint Michael's Medical Center, Newark, New Jersey, USA.
Alpa
A
Patel
Department of Internal Medicine, Saint Michael's Medical Center, Newark, New Jersey, USA.
Moh'd
M
Al-Halawani
Department of Hematology and Oncology, Saint Michael's Medical Center, Newark, New Jersey, USA.
Hamid
H
Shaaban
Department of Pulmonary Medicine, Saint Michael's Medical Center, Newark, New Jersey, USA.
Richard
R
Miller
Adenocarcinoma; lung cancer; skin metastasis