Metastatic Adenocarcinoma

A red papule developed on the scalp of a 52-year-old man who had a history of adenocarcinoma of the lungs. The patient was a former cigarette smoker.

The asymptomatic lesion, which had first appeared 4 weeks earlier, was slowly enlarging. A biopsy of the papule was performed; examination of the tissue revealed metastatic adenocarcinoma.

Dr Reynold C. Wong of Sacramento, Calif, points out that any internal malignancy can metastasize to the skin. Among patients with such metastases, the most common primary tumors are lung, large intestine, ovary, and upper gastrointestinal tract neoplasms. Cutaneous metastases denote a poor prognosis; the mean duration of survival is 3 to 4 months.

This patient died 5 months after the metastatic adenocarcinoma was diagnosed.