Adult urology: CMECutaneous metastases from genitourinary malignancies
Section snippets
Material and methods
A Medline search and manual bibliographic review were performed to identify peer-reviewed articles in the English literature from 1966 to 2003 pertaining to cutaneous metastases from all visceral malignancies. Reports from the literature preceding 1966 were reviewed when cited by subsequent investigators. Cutaneous manifestations of hematologic malignancies were excluded. These data were then collated by primary organ site. Pathologically unsubstantiated cases, as well as all cases of needle
Results
We identified 2369 cases of cutaneous metastases arising from 81,618 primary solid malignancies reported in the literature, for an overall incidence of 2.9%1, 2, 3, 4, 5, 6, 7, 8 (Table I). Dermatologic spread from primary urologic malignancies of the bladder, prostate, or kidney was noted in 116 (1.1%) of 10,417 cases. Of these, 38 cases (0.84%) of cutaneous metastatic transitional cell carcinoma (TCC) from 4516 cases have been reported,2, 5, 6, 7, 8, 9, 10 8 cases (0.36%) of metastatic
Comment
Cutaneous metastases from solid primary tumors are uncommon. Evaluating the largest retrospective studies during the past 65 years, the incidence of metastasis to the skin from visceral malignancies ranged from 0.3% to 9.0% in more than 81,000 recorded cases (Table I).1, 2, 3, 4, 5, 6, 7, 8 The most common primary tumors metastasizing to the skin depend on the sex of the affected individual and include breast (69%) followed by colon (9%), lung (4%), and ovary (4%) in women and lung (24%)
Conclusions
Cutaneous metastases from urologic malignancies are uncommon manifestations of advanced disease. Among genitourinary tumors, metastasis to the skin from RCC is the most common followed by bladder and then prostate tumors. Most lesions occur on the trunk and are multiple and nodular. Their appearance may mimic other dermatologic disorders, and definitive identification requires an index of suspicion and skin biopsy. Recognition of this entity is important for practicing urologists.
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