AB039. Rare case of squamous cell carcinoma of the lung with cutaneous metastasis

Abstract: The description of a case of squamous lung cancer. A 76-year-old male, smoker, 180 pack-years, with a history of COPD and recurrent atrial fibrillation, was admitted because of breathlessness, hoarseness, cough, fatigue and weakness for the past 6 months. There were two cutaneous lesions, well-circumscribed, red and painful, one of whom was located in the inner surface of the left arm and the other was located in the right lower quadrant of the abdomen. The chest CT revealed an infiltrative lesion on the left upper lobe with small nodules around the lesion, extensive necrotic mediastinal lymphadenopathy. The biopsy of the left cutaneous lesion revealed the presence of a squamous metastatic carcinoma of low differentiation which most likely originated from the lungs. The abdomen CT revealed the presence of a nodule on the right adrenal and two round lesions with necrotic content, in the subcutaneous fat of the right abdomen (9.57×12.5 mm) and in the intraperitoneal fat in front of the liver (13.6×9.7 mm) and a lytic lesion on the left pubic bone. The patient was submitted to one course of chemotherapy. Since then he had numerous admissions to hospitals because of breathlessness and fatigue. He passed away five months later with local disease worsening. Metastases to skin from lung cancer are quite rare (2.8–4.9%). They can occur prior, after or synchronously with the lung mass. Large cell carcinoma and adenocarcinoma showed the greatest tendency to spread to the skin while the squamous carcinoma was the rarest. At the development of skin metastases, all cases were accompanied by metastases to other organs and there are only a few cases where they were the unique metastasis. Mean survival after skin involvement is poor (3.9–4.9 months). New skin lesions should be carefully evaluated as they may be related to a yet unknown malignancy.

Keywords: Lung cancer; squamous; cutaneous metastasis