Small cell lung carcinoma with multiple cutaneous metastases as the initial presentation: A rare case report

doi:10.3969/j.issn.1004-583X.2025.01.010

Abstract

Abstract:

Objective To investigate the clinical significance and pathological manifestations of small cell lung carcinoma with multiple skin metastases as the first manifestation. Methods The clinical data of a case of small cell lung carcinoma with multiple skin metastases as the initial manifestation were analyzed retrospectively, and the related literatures were reviewed. Results A 65-year-old male patient without smoking history was admitted due to “growth and enlargement of skin masses on chest, back and waist for 3 months”. With a maximum diameter of 6-12 cm, spherical masses on the surface of the skin were bluish and erosive, tough, and presenting a clear boundary with the surrounding tissue. In addition, the patient had poor appetite since the onset, with a 40-year history of tracheitis. Biopsy of the subcutaneous mass in the right scapular region was performed. Histopathology determined the metastatic nature of the mass consistent with cutaneous metastasis of small cell lung carcinoma. Chest X-ray and magnetic resonance plain scan revealed a large irregular mass in the right hilum of the lung, multiple skin metastases in the bilateral perirenal space, the abdominal cavity and the right scapula, waist and buttocks. Conclusion This rare case shows skin metastases as the first manifestation of primary visceral tumors, which may be the first sign of internal malignancy. Metastasis to the skin is usually a late event that predicts a poor prognosis.

Key words: small cell lung carcinoma, skin metastasis, clinicopathology

CLC Number:

R734.1

Chen Zheyu, He Qianqian, Guo Xiaodong, Wang Huanhuan, Yang Yanli, A Saiguli. Small cell lung carcinoma with multiple cutaneous metastases as the initial presentation: A rare case report[J]. Clinical Focus, 2025, 40(1): 65-69.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2025.01.010

https://huicui.hebmu.edu.cn/EN/Y2025/V40/I1/65

Figures/Tables 3

Fig. 1 Histological results a. Low magnification field of view (40×) showing a large number of tumor cells in the dermis; b. Medium magnification field of view (100×) shows dense tumor-like cell infiltration in the whole dermis and subcutaneous tissue, with diffuse lamellar infiltration or nested arrangement; c, d. The high-magnification field of view (200×, 400×) showed that the size and shape of these tumor cells were basically the same, with small size, round shape, less cytoplasm, more mitotic images, and chrysanthemum cluster structure

Fig. 2 Immunohistochemical results a. Ki67>70%(×100); b. CD56(+)(×100); c.CD99(+)(×100); d.CKp(+)(×100);e. Syn(+)(×100);f.TTF-1(+)(×100)

Fig.3 MRI a. Multiple subcutaneous masses with mixed signal were found in the right hilum, left chest wall, bilateral perirenal space and right shoulder, with clear boundary; b. Multiple subcutaneous mass with restricted diffusion were found in the bilateral perirenal space, waist and pars iliaca, with clear boundary

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