Dr. Hazeena C

BACKGROUND Cutaneous metastases are rare and occur in only 0.6%-10.4% of all malignancies.1,2 Though they are more often seen in the advanced stage of cancer, it may be the first sign of malignancy and can lead to diagnosis of the primary tumour. The magnitude and distribution of cutaneous metastases in North Kerala is not well known. We aimed to categorize the different primaries of the skin metastases and study the demographic and clinicopathological characteristics of cutaneous metastases. METHODS All cases of cutaneous metastases diagnosed either by histopathology or Fine Needle Aspiration Cytology (FNAC) in the Department of Pathology, Government Medical College, Kozhikode, during the seven-year period between October 2010 and September 2017 were studied. Data was retrieved from case records and analysed with the help of computer software SPSS. RESULTS Of 125 cases of cutaneous metastases, 74 cases were diagnosed by FNAC and 51 by histopathology. Most common metastatic deposits were adenocarcinoma (73.6) and squamous cell carcinoma (12%). Primary was unknown in 28.8% cases. The most common primary tumours in males were lung, hepatobiliary system, gastrointestinal (GIT) system and head & neck. In females; breast, genital system, lung, hepatobiliary and GIT were the common primaries. The commonest site of skin deposits was the chest wall. Other common sites included abdominal wall and scalp/head. CONCLUSIONS Skin is an important site of metastatic disease, particularly in patients with carcinoma of breast, lung, hepatobiliary and gastrointestinal systems. FNAC is a rapid and easy technique to diagnose skin metastases. Immunohistochemistry is an efficient ancillary aid in the detection of its origin.