Analysis of 16 cases of skin metastasis of lung cancer
Author: Zhu Youcai DU Kai-Qi Gu-Ping Lee Chih-Hao
Chang Wan-shun Shi Liang also
【Abstract】 Objective To investigate the characteristics of skin metastasis of lung cancer, diagnosis, treatment and prognosis. Method from January 2003 to June 2007 of lung cancer skin metastasis in 16 patients. Pathological examination adenocarcinoma in 7 cases, 5 cases of squamous cell carcinoma, large cell undifferentiated carcinoma, small cell
carcinoma of the 2 cases. 3 cases of resected lung cancer, 11 cases with systemic chemotherapy. The results of chemotherapy, effective 27.3% (RR, 3 / 11). After 14 patients were followed up, 13 patients died, found that the skin be transferred to the time of death of 1.5 ~ 13 months, with a median survival time 3.9 months. Conclusion rare skin metastasis of lung cancer, treatment results are poor, poor prognosis.
Key words lung cancer, skin metastasis
【Abstract】 Objective To explore the character, diagnose and
treatment of skin metastasis of lung cancer. Methods A retrospectic review was carried out on 16 patients with metastasis of lung cancer from Jan, 2003 to Jun, 2007, 12 male and 4 female, the pathologic diagnosis was: 7
cases of adenocarcinoma, 5 cases of squamous cell carcinoma, 2 cases of large cell undifferentiated carcinoma, 2 cases of small cell carcinoma. 3 cases received surgical ablation, 11 cases had chemotherapy. Results The effective rate of chemotherapy was 27.3 % (RR, 3 / 11). 14 cases had followup, 13 cases died. The time length from the discovery of skin metastasis to death was 1.5-13 months, the mean life span was 3.9 months. Conclusions The skin metastasis of lung cancer is rare and the therapeutic
effect is not satisfactory with poor prognosis.
【Key words】 Lung cancer Skin Metastasis
Cutaneous metastasis of lung cancer clinical rare, if there is more
than the transfer of other parts associated with poor prognosis,
diagnosis, relying on pathological examination. Our hospital since January 2003 to June 2007 treated 1537 cases of skin metastasis of lung cancer was found in 16 cases, the report is as follows.
A clinical data
1.1 General Information
16 patients in 12 males and 4 females; aged 48 to 76 years, median 57.4 years of age. In which the upper lobe lung cancer, 10 cases, six cases of lower lobe lung cancer.
1.2 Clinical manifestations
2 cases with skin metastasis as the first symptom, look for the
primary tumor after biopsy and found that lung cancer, 11 cases of lung cancer and also found that the remaining 3 cases of lung cancer, cutaneous metastases after surgical resection. Skin metastasis diameter 0.5 ~ 3cm, manifested as subcutaneous nodules of varying size, quality hardware, the border less clear, poor activity. 3 cases of lesions formed on the surface of skin ulcers was cauliflower-like, the rest of the normal skin color.
Metastasis, 8 cases in the chest and back, abdomen, 4 cases, 3 cases of
head and face, limbs in 1 case. 13 cases of single lesions, ? 2 Ge sites
with multiple skin metastases in 3 cases.
12 cases of skin metastasis was found when the merger other multi-
organ metastasis, of which 5 cases of bone metastasis, brain metastasis,
lung metastasis of all four cases, liver metastasis in 3 cases, kidney and adrenal gland metastasis in 1 case, and only three cases have not found the transfer of other organs.
1.3 after treatment
16 cases of lung cancer surgery in three cases of lung cancer, 2 to 10 months after skin metastasis. 16 cases, 5 cases without systemic treatment, 11 cases systemic chemotherapy (4 cases of localized skin lesion biopsy, 7 patients with local tumor resection). Pathological types:
adenocarcinoma in 7 cases, 5 cases of squamous cell carcinoma, large cell undifferentiated carcinoma, small cell carcinoma of the 2 cases. Non-small
cell lung cancer chemotherapy selected MVP (mitomycin C, Changchun in SUN Shun Platinum), GC (gemcitabine and cisplatin) or NC (Vinorelbine and
cisplatin) program, small cell lung cancer for the EC (etoposide-
carboplatin) program, chemotherapy 2 to 4 cycles after chemotherapy partial remission (PR), stable (SD) of all three cases, disease
progression (PD) 5 Li. 2 cases of brain metastases, bone metastases, adrenal metastasis underwent radiotherapy in 1 case. Reposted elsewhere in the paper for free download http://
1.4 Follow-up and prognosis
2 cases were lost, 14 patients after follow-up, 1 patient survived
the transfer of a single deposit of skin are still alive 10 months and the remaining 13 patients died of other organ metastasis and found that skin and transferred to the time of death of 1.5 ~ 13 months, with a median survival period of 3.9 months.
Cutaneous metastasis from a rare malignant tumor in the metastatic skin tumors, it is common primary tumor male lung, female breast, lung cancer, the incidence of skin metastasis was 2.8% ~ 8.7% . Pemg et al  Statistics 5539 cases of lung cancer, there are 63 cases of skin metastasis, accounting for 1.1%. Information in this group the incidence of 1.04%. The site of metastasis in primary carcinoma of the skin near the office more, to chest and back of the most common, followed by abdominal
wall and the head and face, limbs rare. Cutaneous metastasis from lung cancer, also found more with the lung tumor, and even the skin metastasis as the first symptom of lung cancer were. In this group 2 cases of metastatic carcinoma of the skin biopsy to find the primary tumor and the detection of lung cancer, 3 cases of lung cancer, cutaneous metastases after surgical resection. Therefore, for patients with lung cancer, once the emergence of new skin lesions, should be highly suspected
Transfer possible, biopsy should be timely in order to facilitate timely diagnosis and treatment. Lung has a dual circulation pathway, vascular network is rich in a wide diameter of the lung capillary bed and the lower the resistance, lung cancer, interstitial vascular endothelial cells
decreased immune function and vascular basement membrane is incomplete, susceptible to cancer cell invasion into the arterial circulation path sub-move the skin. Cutaneous metastasis from lung cancer, primary lung
lesions were located on the leaves, may be lung upper lobe because of its anatomy and gravity acting on the blood flow is conducive to the transfer of cancer cells through the bloodstream to the skin. Histological types of lung cancer with skin metastasis have a certain relationship,
adenocarcinoma and large cell carcinoma skin metastasis more likely, squamous cell carcinoma and small cell carcinoma of the skin metastasis of small, this set of data also for multi-adenocarcinoma.
Cancer metastasis is found both inside and outside leather adverse
prognostic factors, treatment ineffective . After the discovery of skin metastasis of lung cancer at the same time it usually involves the
transfer of other organs , such as the transfer to the liver, brain,
bone, lung, adrenal gland and so on, this group found 12 cases of skin and other organs combined transfer of the transfer. Schoenlaub et al  To study the transfer of 228 patients with skin tumors, skin, the median survival time after the transfer was 6.5 months, of which lung cancer was
2.9 months. In the more common skin metastasis-prone tumors, skin, lung
cancer metastasis, the median survival time was the shortest, the worst prognosis. Combined with chemotherapy in this group was 27.3%, lower than
the same program without skin metastasis of lung cancer patients. In spite of active treatment, 14 patients after follow-up, 13 patients died of
other organ metastasis and found that skin and transferred to the time of
death of 1.5 ~ 13 months, with a median survival time 3.9 months. Therefore, skin metastasis of lung cancer means that a high degree of malignancy, survival time is short, attention should be paid.
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