内脏恶性肿瘤皮肤转移50例临床病理分析

Clinicopathological analysis of 50cases of cutaneous metastasis of malignant visceral tumors

目的分析内脏恶性肿瘤皮肤转移的临床表现与组织病理学特征,提高其诊断水平。方法回顾性分析上海市皮肤病医院2012年1月至2018年6月诊治的50例内脏恶性肿瘤皮肤转移患者的皮损特征、肿瘤来源、组织学特征和免疫组化特征等。结果50例患者中男24例,女26例,平均年龄67.0岁(28~93岁),从发现皮肤转移癌到就诊平均4.4个月(2周至13个月)。内脏恶性肿瘤皮肤转移最常见的部位依次为胸部(16例)、下肢(7例)、头颈部(5例)、背部(5例)、腹部(4例)、外生殖器(4例)、上肢(3例),6例同时或先后在多个不同部位出现转移灶。皮损形态以单发的肿块最多见(35例,70%),其他还有多发丘疹结节(13例,26%)、浸润性斑块(1例,2%)和非浸润性红斑(1例,2%)。原发肿瘤以乳腺癌(11例,22%)、肺癌(9例,18%)和胃癌(6例,12%)最常见,组织学类型以腺癌(32例,64%)、鳞状细胞癌(8例,16%)最常见。结论内脏恶性肿瘤皮肤转移好发于老年人,以胸部常见,多表现为单发的肿块,乳腺癌、肺癌、胃癌为最常见的原发肿瘤,组织学类型以腺癌、鳞状细胞癌为主。

Objective To investigate clinical manifestations and histopathological features of cutaneous metastasis of malignant visceral tumors,to improve diagnosis of cutaneous metastasis of malignant visceral tumors.Methods A total of 50patients with cutaneous metastasis of malignant visceral tumors were enrolled from Shanghai Skin Disease Hospital between January 2012and June 2018,and the features of the skin lesions,source of tumors,histological and immunohistochemical features were retrospectively analyzed.Results There were 24males and 26females among the 50patients,with an average age of 67.0years (range,28-93years).The average duration from the notice of cutaneous metastasis of malignant visceral tumors to the first clinic visit was 4.4months (range,2weeks-13 months).Cutaneous metastasis of malignant visceral tumors mostly occurred on the chest (16cases), followed by the lower limbs (7cases),the head and neck (5cases),the back (5cases),the abdomen (4 cases),the external genitalia (4cases)and the upper limbs (3cases).Cutaneous metastasis of malignant visceral tumors simultaneously or successively occurred on multiple sites in 6cases.The most common skin lesion was solitary lump (35cases,70%),followed by multiple papules and nodules (13cases,26%), infiltrative plaques (1case,2%)and non-infiltrative erythema (1case,2%).The most common types of primary cancers were breast cancer (11cases,22%),lung cancer (9cases,18%)and gastric cancer (6 cases,12%),and the most common histological types were adenocarcinoma (32cases,64%)and squamous cell carcinoma (8cases,16%).Conclusions Cutaneous metastasis of malignant visceral tumors mostly occur in the elderly and on the chest.The most common skin lesion was solitary lump.Breast carcinoma, lung cancer and gastric cancer are the most common primary tumors,and adenocarcinoma and squamous cell carcinoma are the most common histological types.