Metastatic cutaneous and subcutaneous deposits from internal carcinoma. An analysis of cases diagnosed by fine needle aspiration.
Thirty-eight cases diagnosed by fine needle aspiration as cutaneous/subcutaneous deposits from internal carcinomas were analyzed. Eighteen patients had undergone previous surgery for primary neoplasms in the breast (9 cases), prostate (1), kidney (1), ovary (1), rectum (3), cervix (1), cheek (1) and periampullary region (1). The metastatic deposits in these cases occurred 1-42 months following removal of the primary neoplasm. Sixteen patients had metastatic deposits occurring simultaneously with the primary tumor in the lung (4 cases), pancreas (1), stomach (3), esophagus (1), ovary (1), rectum (1) anal canal (1), maxillary antrum (1), gallbladder (1), colon (1) and kidney (1). In four patients with metastatic nodules, the primary was undetected in spite of a thorough clinical examination and laboratory investigations. There were five cases of Sister Mary Joseph's nodule (umbilical metastases), four from primary cancer in the abdomen and one in which the primary remained unknown. The deposits were solitary except in one case and were usually less than 2.5 cm in diameter. Adnexal tumor can be a differential diagnosis. Special stains were of little help in such cases, and correlation with the clinical findings was enough to arrive at the diagnosis. Fine needle aspiration provides a rapid morphologic diagnosis in patients with cutaneous/subcutaneous metastatic deposits from internal carcinoma.