SKIN METASTASES FROM RECTAL ADENOCARCINOMA APPEARING ON THE RADIATIONPORT

The case of a 65-year-old woman with skin metastases from rectal adeno carcinoma, occurring in the inguino-perineal area at the site of prior irradiation, is reported. Clinically, the patient showed multiple, ul cerated nodules with firm and raised inflammatory borders on the labia majora and the inguinal folds, surrounded by diffusely indurated and erythematous skin. Left inguinal. adenopathy was also present. Histolo gical examination showed foci of metastatic adenocarcinoma in the supe rficial and middle dermis; microscopic findings consistent with radiat ion dermatitis were also evident. This particular case presented with some uncommon features. Firstly, the skin metastases from rectal adeno carcinoma involved the genital region, which is considered a rare find ing. Also, the clinical presentation was quite impressive. The localiz ation of the cutaneous metastases was in an area of radiation dermatit is corresponding to the portal of prior irradiation. Although the occu rrence of metastases in an area of previous irradiation is relatively rare, the physician should be aware of this possibility. Irradiation, however, is not expected to increase the probability of metastasis at the radiation port, and the role of adjuvant radiation therapy in comb ined treatment regimens to improve local control and/or survival in ca ncer patients remains well-established.