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Dermoscopy of nodular skin metastases from the gastrointestinal primary cancer.

Kamińska-Winciorek G, Wydmański J, Januszewski K, Silny W - Postepy Dermatol Alergol (2015)

View Article: PubMed Central - PubMed

Affiliation: The Center for Cancer Prevention and Treatment, Katowice, Poland. Head of the Center: Beata Wydmańska ; Department of Bone Marrow Transplantation and Oncohematology, The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Gliwice Branch, Gliwice, Poland. Head of the Department: Prof. Sebastian Giebel MD, PhD.

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Dermoscopy is a useful, sufficient and widely used tool for examining pigmented and non-pigmented lesions... It may be helpful as a diagnostic method in the investigation of non-characteristic skin nodules, occurring as solitary, pale or pinkish lesions, especially those of unknown origin or in the event of dealing with an unclear patient history... In dermoscopic evaluation of non-pigmented skin nodules, vascular structures have often played a key diagnostic role, also in the diagnostic management of metastatic skin tumors... Complete regression of metastases to the lung was thus achieved... Nine months later, she was found to have a recurrence of the cancer in her lung and ovary... A slight scaling with superficial subcorneal pustules with granulocytic debris were noted in the superficial part of the epidermis... A slight acanthotic proliferation of the epithelium was found... Proliferation has been observed in the superficial part of the dermis vessels... Also, well-visible multiple, metastatic carcinomatous emboli were found in the lumina of the curved and dilated, spirally elongated vessels... The patient was not qualified for a biopsy of the tumors and was sent to an oncologist... Under clinical examination, further four skin tumors were found on his back... Interstitial fibrosis with hyalinization has also been indicated (Figure 7)... No secondary melanocytic colonization was found in this case... The results of our case studies described two different dermoscopic images of metastatic skin nodules, which originated from cancer of the gastrointestinal tract... Dermoscopy at this stage does not offer much help without any histopathological confirmation, however, in the aspect of unusual clinical presentation of solitary, pinkish nodules, revealing polymorphous vessels leads to a more thorough diagnostic process and increases the index of suspicions of malignancies.

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Related in: MedlinePlus

An example of a macroscopic picture of a metastatic nodule originating from adenocarcinoma of the pancreas. The figure presents a metastatic nodule as non-painful, brownish-pinkish, slightly firm, non-shifting within the skin, sized 2.0 cm in diameter, found on the back of a 61-year-old man
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Figure 0005: An example of a macroscopic picture of a metastatic nodule originating from adenocarcinoma of the pancreas. The figure presents a metastatic nodule as non-painful, brownish-pinkish, slightly firm, non-shifting within the skin, sized 2.0 cm in diameter, found on the back of a 61-year-old man

Mentions: A 61-year-old male patient was diagnosed with a tumor of the pancreas, abdominal lymphadenopathy and multiple liver tumors. The patient was not qualified for a biopsy of the tumors and was sent to an oncologist. Under clinical examination, further four skin tumors were found on his back. The nodules were non-painful, brownish-pinkish, slightly firm, non-shifting within the upper layer of the skin, sized up to 2.0 cm in diameter (Figure 5). A dermoscopy of the metastatic skin nodules showed the presence of a grouping of polymorphous, vaguely visible vessels mainly irregularly distributed, linear straight and linear serpentine in their form. After the application of slight pressure, the vessels rapidly vanished (Figure 6). The background of the nodules was whitish and structure less with several (4) brownish-gray, small roundish dots, irregular in shape and distributed peripherally. The largest tumor was excised and histopathologic examination proved metastatic adenocarcinoma originating from the pancreas. Based on dermoscopy conducted for histopathologic purposes, the final diagnosis of the type of pancreatic malignancy was performed and the patient was qualified for chemotherapy. In a histopathological examination in the superficial part of the dermis, proliferating, curved, slightly dilated and elongated vessels with metastatic, carcinomatous emboli were observed. Interstitial fibrosis with hyalinization has also been indicated (Figure 7). No secondary melanocytic colonization was found in this case.


Dermoscopy of nodular skin metastases from the gastrointestinal primary cancer.

Kamińska-Winciorek G, Wydmański J, Januszewski K, Silny W - Postepy Dermatol Alergol (2015)

An example of a macroscopic picture of a metastatic nodule originating from adenocarcinoma of the pancreas. The figure presents a metastatic nodule as non-painful, brownish-pinkish, slightly firm, non-shifting within the skin, sized 2.0 cm in diameter, found on the back of a 61-year-old man
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4565833&req=5

Figure 0005: An example of a macroscopic picture of a metastatic nodule originating from adenocarcinoma of the pancreas. The figure presents a metastatic nodule as non-painful, brownish-pinkish, slightly firm, non-shifting within the skin, sized 2.0 cm in diameter, found on the back of a 61-year-old man
Mentions: A 61-year-old male patient was diagnosed with a tumor of the pancreas, abdominal lymphadenopathy and multiple liver tumors. The patient was not qualified for a biopsy of the tumors and was sent to an oncologist. Under clinical examination, further four skin tumors were found on his back. The nodules were non-painful, brownish-pinkish, slightly firm, non-shifting within the upper layer of the skin, sized up to 2.0 cm in diameter (Figure 5). A dermoscopy of the metastatic skin nodules showed the presence of a grouping of polymorphous, vaguely visible vessels mainly irregularly distributed, linear straight and linear serpentine in their form. After the application of slight pressure, the vessels rapidly vanished (Figure 6). The background of the nodules was whitish and structure less with several (4) brownish-gray, small roundish dots, irregular in shape and distributed peripherally. The largest tumor was excised and histopathologic examination proved metastatic adenocarcinoma originating from the pancreas. Based on dermoscopy conducted for histopathologic purposes, the final diagnosis of the type of pancreatic malignancy was performed and the patient was qualified for chemotherapy. In a histopathological examination in the superficial part of the dermis, proliferating, curved, slightly dilated and elongated vessels with metastatic, carcinomatous emboli were observed. Interstitial fibrosis with hyalinization has also been indicated (Figure 7). No secondary melanocytic colonization was found in this case.

View Article: PubMed Central - PubMed

Affiliation: The Center for Cancer Prevention and Treatment, Katowice, Poland. Head of the Center: Beata Wydmańska ; Department of Bone Marrow Transplantation and Oncohematology, The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Gliwice Branch, Gliwice, Poland. Head of the Department: Prof. Sebastian Giebel MD, PhD.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dermoscopy is a useful, sufficient and widely used tool for examining pigmented and non-pigmented lesions... It may be helpful as a diagnostic method in the investigation of non-characteristic skin nodules, occurring as solitary, pale or pinkish lesions, especially those of unknown origin or in the event of dealing with an unclear patient history... In dermoscopic evaluation of non-pigmented skin nodules, vascular structures have often played a key diagnostic role, also in the diagnostic management of metastatic skin tumors... Complete regression of metastases to the lung was thus achieved... Nine months later, she was found to have a recurrence of the cancer in her lung and ovary... A slight scaling with superficial subcorneal pustules with granulocytic debris were noted in the superficial part of the epidermis... A slight acanthotic proliferation of the epithelium was found... Proliferation has been observed in the superficial part of the dermis vessels... Also, well-visible multiple, metastatic carcinomatous emboli were found in the lumina of the curved and dilated, spirally elongated vessels... The patient was not qualified for a biopsy of the tumors and was sent to an oncologist... Under clinical examination, further four skin tumors were found on his back... Interstitial fibrosis with hyalinization has also been indicated (Figure 7)... No secondary melanocytic colonization was found in this case... The results of our case studies described two different dermoscopic images of metastatic skin nodules, which originated from cancer of the gastrointestinal tract... Dermoscopy at this stage does not offer much help without any histopathological confirmation, however, in the aspect of unusual clinical presentation of solitary, pinkish nodules, revealing polymorphous vessels leads to a more thorough diagnostic process and increases the index of suspicions of malignancies.

No MeSH data available.


Related in: MedlinePlus