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Cutaneous Metastases

»	How often do internal malignancies metastasize to the skin?
»	By what three routes do internal malignancies metastasize to the skin?
»	How do malignant cells invade and metastasize?
»	What are the most common cancers that metastasize to the skin in women?
»	What are the most common cancers that metastasize to the skin in men?
»	Do metastases to the skin typically occur in random patterns?
»	Describe the most common presentations of malignancies metastatic to the skin.
»	What is alopecia neoplastica?
»	What is a Sister Mary Joseph’s nodule?
»	Which tumors usually present as a Sister Mary Joseph’s nodule?
»	Does basal cell carcinoma ever metastasize?
»	How do you diagnose a cutaneous metastasis?
»	What is the prognosis of a patient with a cutaneous metastasis?

By what three routes do internal malignancies metastasize to the skin?

They extend by local infiltration, lymphatic spread, or hematogenous spread. Breast carcinoma and oral cancer are the most likely to demonstrate direct extension into the skin. It is assumed that the fundamental mechanisms are similar to those of metastasis to parenchymal organs, but this has not been investigated. Rare cases have been inoculated by local procedures such as needle biopsies.

Jilani G, Mohamed D, Wadia H, et al: Cutaneous metastasis of renal cell carcinoma through percutaneous fine needle aspiration biopsy: case report, Dermatol Online J 15:10, 2010.