Bădescu Magda Mariana MD, PhD
University of Medicine and Pharmacy “Grigore T. Popa”, Iaşi
Skin: A mirror of internal malignancy
Authors: Magda Bădescu, Manuela Ciocoiu, B.M. Diaconescu, Codruța Bădescu
Introduction: Tegument behaves like a mirror for various underlying conditions, especially malignant tumors. Skin lesion may sometimes be the only symptom of the underlying disease. Material and Method: Several different studies involving a total of 712 patients with internal malignant tumors who were hospitalized for a period of 5 years. All cutaneous metastases have been examined and diagnosed. Results: Cutaneous metastases occur in 1% – 9% of all patients with internal cancer. The most common skin metastases in a previously unknown primary tumor originate from the kidneys, lungs, thyroid or ovary, and are most commonly found (75%) in the head, neck, and upper trunk. Metastatic carcinomas are usually differentiated from the primary carcinomas of the skin due to their typical histological patterns. If the distinction between metastatic and primary skin tumors is difficult, a variety of immunohistochemical staining panels are useful. Positivity for cytokeratin 7 (CK 7) (GCDFP), estrogen receptor (ER) and progesterone receptor (PR) indicates mammary origin, while positivity of thyroid transcription factor (TTF-1) evokes primary adenocarcinoma or thyroid and is not present in primary skin tumors. P63 is a positive marker of only primary and negative tumors in metastases. Conclusions: Cutaneous metastases provide an opportunity to detect potentially treatable cancer before other evidence of its presence, to modify therapy as appropriate in the tumor stage, or to use cutaneous lesions as a source of tumor cells readily available for specific therapy.