Cutaneous Lesions: An Unusual Clinical Presentation of Small Cell Lung Cancer

Patient: Male, 87-year-old Final Diagnosis: Small cell lung cancer Symptoms: Cutaneous lesions Medication:— Clinical Procedure: — Specialty: Oncology • Surgery OBJECTIVE: Unusual clinical course BACKGROUND: Small cell lung cancer (SCLC) is the most aggressive type of lung cancer, accounting for 13% of all new lung cancer cases worldwide. Common metastatic sites are the brain, liver, adrenal glands, bone, and bone marrow, while cutaneous metastasis is rare and is associated with a poor prognosis, and presentation of SCLC as the first sign of malignancy is even rarer. CASE REPORT: An 87-year-old patient with a history of tobacco abuse and free from any medication administration presented to the Emergency Surgical Department with 2 nodules in the skin of the abdomen. Excisional biopsy of the skin lesions was performed and the pathology showed metastatic small cell cancer originated from the lungs. A chest X-ray and CT scan confirmed the diagnosis of lung cancer. Chemotherapy was initiated. Following a short hospitalization period, the patient’s condition worsened. The patient died in the Intensive Care Unit before completion of full cycles of chemotherapy and palliative radiation therapy. CONCLUSIONS: A diagnosis of metastatic disease should be considered in patients with new cutaneous lesions and a smoking history. Skin lesions of metastatic lung cancer are often described as painless nodules, mobile or fixed, hard or flexible, single or multiple. Treatment in limited-stage disease usually includes chemotherapy combined with radiation. In extensive-stage disease, chemotherapy is the primary option. Small cell lung carcinoma is more responsive to chemotherapy and radiation therapy than are other cell types of lung cancer. For prevention, especially in high-risk patients, annual chest screening, smoking-prevention programs, and control of occupational exposure to culprit substances are highly recommended.