Zosteriform metastatic skin cancer: Report of three cases and review of the literature

Background: Metastatic skin cancer is a rare complication of internal malig nancies. Patients who do develop skin metastases seldom present with a zost eriform distribution. Objective: To elucidate the characteristics of zoster iform metastatic skin cancer, 15 cases from the medical literature and 3 ca ses seen in our clinic were reviewed clinically and histopathologically. Me thods: The age and sex of each patient, site of the primary tumor, patholog y of primary and metastatic lesions, location of the skin cancer and presen ce of pain were determined for the 18 cases of zosteriform skin cancer. Res ults: The most frequent site of the primary tumor was the breast (4 cases), ovary or lung (3 cases each), prostate, bladder or stomach (2 cases each) and uterus or colon (1 case each). The most common site of the skin metasta ses was the chest wall (8 cases) and abdominal wall (7 cases). The histolog y of the primary lesion was compatible with adenocarcinoma (10 cases), tran sitional cell carcinoma or serous papillary cystadenocarcinoma (2 cases eac h) and ductal carcinoma (1 case). Eleven cases developed on the nearest cov ering skin and/or on the same side as the primary tumor. Eleven patients co mplained of pain. Seven cases were treated as herpes tester with antiviral agents. Conclusion: Approximately 50% of cases of metastatic skin cancer de veloped on the nearest skin covering and on the same side as the primary tu mor. This evidence may be useful when trying to pinpoint the location of th e primary tumor. One third of patients with skin metastases were misdiagnos ed and their lesions were treated initially as herpes tester. When a band-l ike eruption is seen in patients with internal malignancies, the possibilit y of metastatic skin lesions should be considered. A skin biopsy is necessa ry to confirm the diagnosis. Copyright (C) 2001 S. Karger AG, Basel.