Most malignant tumours can produce cutaneous metastases, which are usually late events in the course of internal malignancy. The skin metastases are usually more vascular than normal skin, and may appear to be inflammatory rather than neoplastic in nature. In breast cancer, cutaneous metastases may take the form of inflammatory plaques with a clear-cut raised margin resembling erysipelas (carcinoma erysipeloides). In lung carcinoma, reddish nodules which suddenly appear in the skin present a characteristic clinical picture. The firm nodules tend to follow the direction of the intercostal vessels when they appear on the chest. Hypernephroma can produce solitary deposits in the skin which are vascular or even pulsatile and tend to be pedunculated. In neuroblastoma, one of the most common malignant tumours of early childhood, cutaneous metastases present as firm, bluish nodules that blanch for 30 - 60 min after palpation followed by a 1 - 2-h refractory period.
Skin Metastases of Tumours of Internal Organs