Cutaneous metastasis on the nasal tip: first clinical sign of pulmonary carcinoid tumor

Abstract

Skin metastases are rare and may occur in the context of a known metastatic disease or be the first clinical sign of an underlying primary tumor. In the case of carcinoid neoplasms, determining whether the cutaneous tumor is primary or secondary and identifying the tumor origin in metastatic cases is not always an easy task. This is the report of a case of cutaneous metastasis presenting as the first clinical manifestation of a previously unknown pulmonary carcinoid tumor, including the discussion of histopathological and immunohistochemical findings that allowed an adequate diagnosis of the tumor etiology and reinforces the importance for dermatologists and dermatopathologists to be familiar with these findings.

Cutaneous metastases with different clinical presentations: case series and review of the literature

“…TTF-1 has high sensitivity and specificity for carcinoid tumours originating in the lung, whereas CDX2 expression is highly specific for tumors of gastrointestinal origin. Although rare, cutaneous metastasis of carcinoid tumours may represent the first sign of an unknown primary neuroendocrine tumor [12].…”

Skin and Subcutaneous Tissue Metastases of the Pulmonary Carcinoid Tumor on 68Ga-DOTATATE PET/CT

“…5,6 Metastasis of pulmonary carcinoids to the skin and subcutaneous tissue is extremely rare and has been reported in only a few cases. [7][8][9][10] In addition, no case of skin and subcutaneous tissue metastasis of pulmonary carcinoid on 68 Ga-DOTATATE PET/CT has been reported in the literature yet. We described an intriguing case of extensive skin, subcutaneous tissue, thyroid, and intramuscular metastases of a pulmonary carcinoid tumor that illustrates the importance of 68 Ga-DOTATATE PET/CT in detecting the recurrence of neuroendocrine tumors.…”

“…Advanced pulmonary carcinoids most frequently metastasize to the mediastinal lymph nodes, liver, and bones 5,6 . Metastasis of pulmonary carcinoids to the skin and subcutaneous tissue is extremely rare and has been reported in only a few cases 7–10 . In addition, no case of skin and subcutaneous tissue metastasis of pulmonary carcinoid on 68 Ga-DOTATATE PET/CT has been reported in the literature yet.…”