Nodules cutanés négligés révélant un adénocarcinome pulmonaire

Abstract

We report the case of a 45 year old patient with nicotine dependence, smoking 20 packs year presenting for oncology consultation with multiple subcutaneous nodules over the abdomen associated with an ulcerated lesion in the right hypochondrium measuring 10x10cm which progressed rapidly over less than two months. Biopsy showed secondary adenocarcinoma. Immunohistochemical study revealed that adenocarcinoma was of bronchopulmonary origin (TTF1 and CK7 positives). Staging thoraco-abdominal-pelvic CT scan objectified tumor in the right lung; palliative chemotherapy was indicated. Lung cancer is often diagnosed at a metastatic stage, with a predilection for lymph node, pleural, contralateral lung, brain, bone and adrenal localization; otherwise cutaneous metastases are rare with an incidence of 2.9- 5.3% for all cancers and 1-12% for lung cancer. The lesions are often made of single or multiple motionless hard nodules with a size ranging from 0.5 to 10 cm; cutaneous metastases of pulmonary origin are often adenocarcinoma followed by squamous cell carcinoma and small cell lung cancer. Our patient had multiple subcutaneous metastases of which one was ulcerated.

The Pan African Medical Journal 2016;24