An unusual skin nodule
Over the past 2 months, the patient lost 20 pounds and noticed “bumps” on her body.
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
