Metastatic Carcinoma


Cutaneous metastases occur in approximately 10% of all cancer patients. The frequencies of cutaneous metastases correlate directly with the frequencies of primary malignancies. In women, breast carcinoma is the most common tumor to spread to the skin, followed by large intestine, melanoma, lung, and ovary. In men, primary tumors from the lung most commonly involve the skin, followed by tumors of the large intestine, melanoma, and squamous cell carcinomas of the oral cavity (1). Metastases can affect any part of the body, with a disproportionate number involving the scalp (presumably due to increased circulatory volume). Overall, skin metastases represent the presenting sign of underlying malignancy in about 8% of these patients (2). Umbilical metastases have been given the designation Sister Mary Joseph nodules, named for a nurse involved with the first surgical resection of such a lesion. Umbilical metastases involve from 5% to 10% of tumors involving the abdomen and may be the presenting sign of an internal malignancy in up to 45% of cases. In one study, 57% of tumor nodules located in the umbilicus were benign (3). Neoplasms originating in the gastrointestinal tract account for the great majority of the metastatic processes (Table 8.1) (1). Other primary neoplasms with umbilical metastases have been reported less commonly. These include adenocarcinomas of the gall bladder (4), renal cell carcinoma (5), and lymphoma (6).


Renal Cell Carcinoma Gallbladder Carcinoma Metastatic Carcinoma Cutaneous Metastasis Skin Metastasis 
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