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April 1991

Solitary Papule of the Lip in Recurrent Gastroesophageal Carcinoma: An Unusual Presentation of Cutaneous Metastasis

Author Affiliations

Department of Dermatology

Department of Medicine Boston University School of Medicine 80 E Concord St Boston, MA 02118

Arch Dermatol. 1991;127(4):588-589. doi:10.1001/archderm.1991.04510010156029

To the Editor.  —Cutaneous metastases usually arise in the region of the primary tumor, are multiple, and are associated with concomitant metastases to internal organs and lymph nodes. We describe an unusual case of recurrent gastroesophageal carcinoma manifesting as a solitary cutaneous metastasis to the upper lip in a patient with no other evidence of distant disseminated disease.

Report of a Case.  —A 48-year-old white man presented in September 1986, reporting epigastric pain, reflux, dysphagia, and intermittent hematochezia.Upper endoscopy and subsequent laparotomy revealed a hard tumor of the gastroesophageal junction with extension into the fundus and penetration through the lesser curvature. There were no gross nodal or liver metastases. An esophagogastrectomy with esophagogastrostomy was performed. Pathologic findings showed poorly to moderately differentiated adenocarcinoma, with clear surgical margins and four of 10 perigastric lymph nodes positive for metastatic adenocarcinoma.

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