A few cases of pigmented squamous cell carcinoma affecting the skin and the ocular and oral mucosa of the elderly have been described in the literature. The disease manifests itself as papular and nodular erythematous or pigmented lesions. The main clinical differential diagnoses are pigmented basal cell carcinoma and melanoma. Histopathological examination is characterized by proliferation of atypical squamous cells with formation of horn pearls permeated by dendritic melanocytes. For this reason, a careful diagnosis is necessary to rule out other tumors that show melanin pigment. Surgical removal is the indicated treatment and the prognosis is similar to the classical squamous cell carcinoma. We report a case of pigmented squamous cell carcinoma with diagnosis confirmed by histological and immunohistochemical examinations.

Cutaneous metastases are uncommon in daily practice, although very important, since they may be the first manifestation of an undiscovered primary neoplasm or the first indication of recurrence. Cutaneous metastases from the breast are the most frequent in women and cutaneous metastases from the lung are the most frequent in men. Thyroid carcinoma, despite representing the most frequent endocrine neoplasm, is considered a rare neoplasm, corresponding to 1% of malignant neoplasms diagnosed. Cutaneous metastases from follicular carcinoma are rare and occur mainly in the head and neck area. We report a case of cutaneous metastasis in a patient with follicular thyroid carcinoma and breast carcinoma. Because of the association of these two neoplasms, the possibility of Cowden Syndrome - multiple hamartoma syndrome - was raised, but was excluded by genetic analysis of PTEN gene.