Photo Rounds

An unusual skin nodule

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References

A grim prognosis

Current therapies for skin metastases from primary lung carcinomas include surgical excision, symptomatic therapy, and chemotherapy—with and without radiation. After a patient’s course of treatment, skin metastases may be an important diagnostic marker for tumor recurrence.

Kamiyoshihara et al8 found that when skin metastases are detected, only 23% of the underlying primary cancers are operable, noting that most “portent a fatal outcome.”

Our patient declined further treatment

A CT of the patient’s chest showed a left hilar mass. A radionucleotide bone scan revealed metastases to the right elbow. We estimated that our patient had 1 year to live. In light of her very dismal prognosis, our patient declined any further work-up or treatment.

Our patient died 5 months later.

Correspondence
David A. Kasper DO, MBA, 2064 West Market St., Potts-ville, PA 17901; davidkas@pcom.edu

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