eMedicine Specialties > Dermatology > Malignant Neoplasms

Metastatic Carcinoma of the Skin: Treatment & Medication

Author: Thomas N Helm, MD, Clinical Associate Professor, Departments of Dermatology and Pathology, State University of New York at Buffalo; Director, Buffalo Medical Group Dermatopathology Laboratory
Coauthor(s): Thomas C Lee, MD, Intern, Department of Internal Medicine, New York University School of Medicine
Contributor Information and Disclosures

Updated: Aug 14, 2008

Treatment

Medical Care

  • Effective treatment depends on treatment of the underlying tumor. Palliative care is given if lesions are asymptomatic and the primary cancer is untreatable. This care includes keeping lesions clean and dry and debriding the lesions if they are bleeding or crusted. Hydrocolloid dressings may be used to help prevent secondary infection.
  • Studies indicate that imiquimod 5% cream (Aldara) may lead to regression of metastasis in some cases of melanoma.
  • Liquid nitrogen cryotherapy, photodynamic therapy, and conventional surgery also may be useful for palliation of skin metastasis.
  • Short wavelength radiation therapy may be helpful to provide symptomatic relief for painful lesions, using superficial electron beam therapy. Cryotherapy with temperature probe control, carbon dioxide laser therapy,5,6 electrochemotherapy,7 and other treatment approaches may also be of value. Pulsed dye laser may be of value to reduce blood flow to highly vascularized metastases. Intralesional chemotherapy and cytokines can be helpful, and topical retinoids or immune modulators, such as imiquimod, offer promise in select cases.

Surgical Care

In many cases, cutaneous metastasis can cause disfigurement or social embarrassment, or it can diminish the quality of the patient's life. Excision and removal of metastasis may be warranted to enhance the patient's quality of life, but they do little to increase survival. Simple excision is usually the treatment of choice.

Medication

Medical therapy is limited to treatment of the underlying neoplasm. Surgical approaches are generally most effective as a temporizing measure for cutaneous metastases. Medical camouflage with cosmetics (eg, Dermablend) may be of value to disguise visible metastases for cosmetic purposes.

More on Metastatic Carcinoma of the Skin

Overview: Metastatic Carcinoma of the Skin
Differential Diagnoses & Workup: Metastatic Carcinoma of the Skin
Treatment & Medication: Metastatic Carcinoma of the Skin
Follow-up: Metastatic Carcinoma of the Skin
Multimedia: Metastatic Carcinoma of the Skin
References
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References

  1. Krathen RA, Orengo IF, Rosen T. Cutaneous metastasis: a meta-analysis of data. South Med J. Feb 2003;96(2):164-7. [Medline].

  2. Chung MH, Gupta RK, Essner R, Ye W, Yee R, Morton DL. Serum TA90 immune complex assay can predict outcome after resection of thick (> or =4 mm) primary melanoma and sentinel lymphadenectomy. Ann Surg Oncol. Mar 2002;9(2):120-6. [Medline].

  3. Cassarino DS, Cabral ES, Kartha RV, Swetter SM. Primary dermal melanoma: distinct immunohistochemical findings and clinical outcome compared with nodular and metastatic melanoma. Archives of Dermatology. January 2008;144:49-56. [Medline].

  4. Requena L, Sangueza M, Sangueza O, Kutzner H. Pigmented mammary Paget disease and pigmented epidermotropic metastases from breast carcinoma. American Journal of Dermatopathology. June 2002;24:189-98. [Medline].

  5. Hill S, Thomas JM. Use of the carbon dioxide laser to manage cutaneous metastases from malignant melanoma. Br J Surg. Apr 1996;83(4):509-12. [Medline].

  6. Lingam MK, McKay AJ. Carbon dioxide laser ablation as an alternative treatment for cutaneous metastases from malignant melanoma. Br J Surg. Oct 1995;82(10):1346-8. [Medline].

  7. Kubota Y, Mir LM, Nakada T, Sasagawa I, Suzuki H, Aoyama N. Successful treatment of metastatic skin lesions with electrochemotherapy. J Urol. Oct 1998;160(4):1426. [Medline].

  8. Brownstein MH, Helwig EB. Metastatic tumors of the skin. Cancer. May 1972;29(5):1298-307. [Medline].

  9. Healey PM, Malott K, Chalet MD. Cancers metastatic to the skin. In: Friedman RJ, Rigel DS, Harris MN, Baker D. Cancer of the Skin. Philadelphia, Pa: WB Saunders; 1991:347-63.

  10. Lookingbill DP, Helm KF. Metastatic tumors. In: Demis J. Clinical Dermatology. Philadelphia, Pa: Lippincott-Raven; 1997:1-7.

  11. Resnik KS, DiLeonardo M, Gibbons G. Clinically occult cutaneous metastases. J Am Acad Dermatol. Dec 2006;55(6):1044-7. [Medline].

  12. Sahin S, Hindioglu U, Benekli M, Sivri B, Sökmensüer C, Sungur A. Peculiar inflammatory cutaneous metastasis from stomach adenocarcinoma. Br J Dermatol. Apr 1997;136(4):650-2. [Medline].

  13. Schwartz RA. Metastatic cancer of the skin. In: Skin Cancer Recognition and Management. New York, NY: Springer-Verlag; 1998:185-93.

  14. Spencer PS, Helm TN. Skin metastases in cancer patients. Cutis. Feb 1987;39(2):119-21. [Medline].

  15. Steck WD, Helwig EB. Tumors of the umbilicus. Cancer. Jul 1965;18:907-15. [Medline].

  16. Strohl RA. Cutaneous manifestations of malignant disease. Dermatol Nurs. Feb 1998;10(1):23-5. [Medline].

  17. Tschen EH, Apisarnthanarax P. Inflammatory metastatic carcinoma of the breast. Arch Dermatol. Feb 1981;117(2):120-1. [Medline].

  18. Zalla MJ, Roenigk RK. Metastatic carcinoma. In: Maloney M, Helm KF. Surgical Dermatopathology. Malden, Mass: Blackwell; 1999:389-436.

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Further Reading

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Keywords

skin cancer, cancer metastasis, carcinoma metastasis, cutaneous metastases, cutaneous metastasis, skin carcinoma, skin metastasis, skin metastases

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Contributor Information and Disclosures

Author

Thomas N Helm, MD, Clinical Associate Professor, Departments of Dermatology and Pathology, State University of New York at Buffalo; Director, Buffalo Medical Group Dermatopathology Laboratory
Thomas N Helm, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society for Dermatologic Surgery, and American Society of Dermatopathology
Disclosure: Nothing to disclose.

Coauthor(s)

Thomas C Lee, MD, Intern, Department of Internal Medicine, New York University School of Medicine
Disclosure: Nothing to disclose.

Medical Editor

Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Warren R Heymann, MD, Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey
Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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