Cutaneous Metastases: An Update on Their Origins and Clinical Presentations

Introduction: Cutaneous metastases can originate from different organ systems and reach the skin through various pathways. Hence, they can present in a wide range of clinical patterns. Objectives: We aimed to evaluate the clinical features of cutaneous metastases in a large, well-documented series and compare them with the literature. Methods: Patients diagnosed with cutaneous metastasis in a 20-year period were evaluated in this retrospective single-center study. Metastases of hematologic malignancies, melanoma, and major epithelial malignancies of skin were excluded. Results: In all, 105 patients were included in the study. The most common primary origin was breast (n=42), followed by oral and nasal mucosal squamous cell carcinoma (SCC) (n=7), and gastric cancer (n=6). Chest was the most commonly involved site (n=51), followed by head (n=26). Breast cancer and mucosal SCC tended to metastasize locally, while colon, bladder, lung, and gastric cancers had higher rates of distant metastasis. Fourteen patients (13.3%) presented with multiple clinical patterns. Patients most commonly presented with nodules (n=81), although sclerodermoid (n=12), carcinoma erysipeloides (n=11), and erythema annulare centrifugum-like (EAC-like) (n=9) presentations were observed at a higher rate than the literature. Among various nodular patterns, multiple isolated nodules were the most common. Ulceration was observed at the highest rate in the literature (31.4%), and was mostly associated with nodular metastases. Conclusions: Cutaneous metastases can have a variety of presentations, sometimes with multiple patterns observed simultaneously. In the differential diagnosis of persistent EAC-like lesions, circumscribed sclerodermoid lesions, and ulcerated nodules not otherwise explained, cutaneous metastases should be considered.