Skin Metastasis from Cervical Adenocarcinoma with Intrapulmonary Metastasis and Metachronous Ovarian Cancer Responding to Chemotherapy: A Case Report and Review

Skin metastasis, a rare occurrence in cervical cancer, typically signifies advanced systemic disease with a poor prognosis. This case report presents a 55-year-old female with recurrent cervical adenocarcinoma, intrapulmonary metastasis, and metachronous mucinous ovarian cancer who developed skin metastasis. The patient presented with skin-colored and hyperpigmented plaques and papules on the lower abdomen. The histopathological examination of the skin lesion from the patient in this case report revealed subepithelial tumor masses composed of round to oval cells growing hyperplastically in compact clusters, with some forming glandular structures. The nuclei exhibited pleomorphism, ranging from hyperchromatic to vesicular, with clear nucleoli, and mitotic figures were observed. The fibrocollagenous stroma appeared partly edematous, while the skin adnexa, including the sweat and sebaceous glands, remained intact. Immunohistochemical staining for p16 in the skin lesion showed strong positivity in stromal tumor cell infiltrates and negativity in the papillary epithelium, supporting a metastatic origin from cervical adenocarcinoma, confirming the diagnosis of skin metastasis from adenocarcinoma. She was treated with three cycles of paclitaxel and carboplatin chemotherapy, resulting in thinning and a reduction in the size and number of plaques and papules. Despite the positive therapeutic response, the overall prognosis remains poor, and she passed away 16 months after the initial appearance of skin metastasis. This case underscores the importance of routine skin examination in cervical cancer patients, as skin metastasis often correlates with advanced disease and distant organ involvement. Early biopsy and prompt treatment may enhance progression-free survival in such cases.