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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?

Does basal cell carcinoma ever metastasize?

Yes. Basal cell carcinoma is the most common cutaneous malignancy in the United States with over 1 million new cases per year. It has been estimated that the overall metastatic rate is 0.03% with the majority of cases occurring in large destructive tumors that have been present for many years. Basal cell carcinomas most commonly metastasize to regional lymph nodes followed by the lungs, bones, and skin. The 5-year survival for metastatic basal cell carcinoma is grave and is estimated to be about 10%.

Spates ST, Mellette JR Jr, Fitzpatrick J: Metastatic basal cell carcinoma, Dermatol Surg 29:650–652, 2003.