E3399. Cutaneous Manifestations of Noncutaneous Malignancies: A Pictorial Review
Authors
Gregg Blumberg;
NYU Langone Hospital - Long Island
Luis Colon-Flores;
NYU Langone Hospital - Long Island
Miltiadis Tembelis;
NYU Langone Hospital - Long Island
Aranz Khalilollahi;
NYU Langone Hospital - Long Island
Armin Mahabadi;
NYU Langone Hospital - Long Island
Douglas Katz;
NYU Langone Hospital - Long Island
Anca Kranz;
NYU Langone Hospital - Long Island
Background
Cutaneous tumoral foci typically lead radiologists to consider primary malignancies including melanoma, mycosis fungoides, squamous cell carcinoma and benign entities. However, cutaneous and subcutaneous (CSQ) metastatic disease is more common than realized, and is seen in a variety of internal malignancies from multiple organ systems. CSQ foci can often be the first sign of extranodal disease, particularly in patients with known internal malignancies. Certain malignancies are more common to produce this type of tumoral spread than others, particularly lung, mucosal head/neck, breast cancer in women, and renal cell carcinoma. Early recognition by the interpreting radiologist is essential, as prompt biopsy can help localize unknown primary malignancies and upstage known primary malignancies, thus affecting prognosis. To do so, radiologists should have an understanding of the patient’s history, the CSQ recurrence pattern of each internal malignancy, as well as its effect on prognosis.
Educational Goals / Teaching Points
The objective is to become aware of and better understand the abundance of primary internal malignancies that more commonly metastasize to the CSQ tissues. We will discuss the location and pattern of CSQ metastatic disease and associated primary malignancies. The importance of having this background knowledge will be emphasized, as well as its effect on patient prognosis.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will provide a pictorial review of primary internal malignancies over multiple organ systems that presented with CSQ metastatic disease. Patient history, PET/CT findings, common CSQ recurrence patterns, and a brief literature review of each internal malignancy will all be discussed.
Conclusion
CSQ metastatic disease can be seen in several primary internal malignancies, with some more common than others. Since morphologic imaging features can be nonspecific, the patient’s history is crucial to reaching a proper diagnosis. An early detection and prompt suspicion for CSQ metastatic disease is essential, as this can affect patient prognosis.
