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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?

What are the most common cancers that metastasize to the skin in men?

Heavily pigmented metastatic melanoma due to in transit metastases from a primary tumor on the lower extremity. (Courtesy of Rene Gonzalez, MD.)

Fig. 48.1 Heavily pigmented metastatic melanoma due to in transit metastases from a primary tumor on the lower extremity. (Courtesy of Rene Gonzalez, MD.)

In the same study, the five most common causes of skin metastases in men were:
• Lung: 24%
• Colon: 19%
• Malignant melanoma: 13%
• Oral squamous cell carcinoma: 12%
• Kidney: 6%

In a more recent study, malignant melanoma was the most common cause of cutaneous metastases, accounting for 32% of all cases (Fig. 48-1).