Nasal Tip Cutaneous Metastases Secondary to Lung Carcinoma: Three Case Reports and a Review of the Literature

Abstract

Cutaneous metastatic carcinoma of the nose is a rare presentation associated with lung cancer. We report here 3 cases of cutaneous metastatic carcinoma of the nose that originated from lung cancer. Two men, age 61 and 76 years, with lung cancers were referred for evaluation of a tumour on the tip of the nose. The third patient, a 57-year-old man, had developed a rosacea-like tumour on the tip of the nose; although he had no history of internal cancer, whole-body positron-emission tomography-computed tomography revealed a primary lung cancer. Skin biopsies of all 3 cases showed metastatic squamous cell carcinoma, and all primary lung cancers were squamous cell carcinomas. Only 3 patients are described here, and further reports are needed to substantiate this interesting phenomenon. When an elderly patient presents to dermatology with a tumour on the nose with or without known internal cancer, it is necessary to approach the diagnosis with caution.

Update of Clown Nose-Like Lesion, a Underrecognized Manifestation of Metastatic Malignancies and Genetic Cancer Predisposition Syndromes

“…Detailed medical history, tissue biopsy, and systematic examination are necessary. The percentage of patients with cutaneous metastases originating from visceral cancers are ~0.7–9% ( 55 ), in which lung cancer metastasis happened in 1–12% of cases ( 2 , 56 ). Metastatic transmission to the skin can occur in the following ways: lymphatic transmission, blood-borne transmission, direct continuity, and rarely iatrogenic implantation ( 57 ).…”

“…Metastatic transmission to the skin can occur in the following ways: lymphatic transmission, blood-borne transmission, direct continuity, and rarely iatrogenic implantation ( 57 ). Under most circumstances, the tumor will preferentially metastasize to the nearby skin, and distant metastasis to the skin is relatively rare ( 2 ). The mechanism of cancer metastasis to the nose has not been fully elucidated.…”

“…Clown nose-like lesion refers to the manifestation of a reddish or skin-colored bulge on the tip of the nose or the manifestation of bulbous tip of the nose, resembling the fake nose of a clown ( 1 ). Initially, clown nose-like lesion was considered as a indicator of cutaneous metastatic malignancies, including lung cancer ( 2 ), renal clear cell carcinoma ( 3 ), rhabdomyosarcoma ( 4 ), cervical cancer ( 5 ), and liver cancer ( 6 ). In clinical practice, however, it can also be a cue for genetic syndromes, such as Tricho-Rhino-Phalangeal syndrome ( 7 ), as well as some primary nasal diseases including infections such as leishmaniasis ( 8 ), inflammations such as rosacea ( 9 ), and tumors such as keratoacanthoma ( 10 ).…”

Metastatic papillary thyroid carcinoma to the nose: report and review of cutaneous metastases of papillary thyroid cancer

“…The nose is an unusual site for cutaneous metastases. In addition to thyroid carcinoma, other cancers with metastatic lesions on the nose include solid tumors originating from the breast, cervix, liver, lung and testes [ 13 ]; immunohistochemical markers can be used to differentiate the organ of origin of these metastatic tumors ( Table 1 ). The described patient was referred for evaluation of a suspected basal cell carcinoma.…”

Signo de la nariz de payaso como manifestaci�n de neoplasia pulmonar

“…No se conoce con certeza el mecanismo fisiopatológico por el cual ocurre este fenómeno 18 , pero Baston sugirió en 1940 la migración de células tumorales a través de vasos sanguíneos y linfáticos pulmonares 19 . Otros mecanismos son el embolismo de células tumorales a través de plexos venosos hasta los senos venosos del cráneo por elevación de la presión intratorácica y de allí la extensión a la punta nasal 18 . Nuevos informes sugieren implantación yatrogénica de células tumorales cuando existe comunicación entre el tumor primario con la nariz (uso crónico de sonda nasogástrica) 20 .…”