Skin metastases from gastric cancer, a rare entity masquerading as erysipelas: A case report

Abstract

Gastric cancer (GC) is the fifth most commonly diagnosed malignancy and the fourth leading cause of cancer death worldwide. Skin metastases from internal organs are rare; skin metastasis from GC occurs even more rarely than skin metastases originating from other organs, and is associated with systematic disease and poor prognosis. The present study described an interesting and rare case of an extensive skin rash in a 42-year-old man diagnosed with GC, which was mainly affecting his left hemithorax, abdomen and back. The rash masqueraded as erysipelas and was initially treated as such; however, it did not respond to antibiotics, corticosteroids and antihistamines. Due to its persistence and location, the rash was biopsied and GC metastasis was confirmed. Third-line chemotherapy was administered and the rash decreased in size; however, the patient suffered from disease deterioration with lung metastases and respiratory failure. The patient eventually died 4 months after the diagnosis of skin metastasis. In conclusion, cutaneous metastasis should be considered as a late and difficult to treat metastasis of GC, which requires high surveillance from medical oncologists, and a multidisciplinary approach for prompt and accurate diagnosis.

Keywords: cutaneous metastasis; erysipelas; gastric cancer; skin metastasis; stomach cancer.

Figure 1

Skin metastases from gastric cancer. The 42-year-old man presented with extensive rash in his left hemithorax, abdomen and back accompanied by mild pruritus and low fever, about 13 months after his initial diagnosis; the rash was initially treated as erysipelas.

Figure 2

The extensive rash did not response to pharmaceutical therapy. Due to its persistence and location, a skin biopsy was obtained and confirmed the diagnosis of a low-grade carcinoma, consistent with metastasis from the known gastric cancer.