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European Journal of Dermatology

Skin metastases from rectal adenocarcinoma appearing on the radiation port Volume 7, issue 2, March 1997

Résumé : The case of a 65-year-old woman with skin metastases from rectal adenocarcinoma, occurring in the inguino-perineal area at the site of prior irradiation, is reported. Clinically, the patient showed multiple, ulcerated nodules with firm and raised inflammatory borders on the labia majora and the inguinal folds, surrounded by diffusely indurated and erythematous skin. Left inguinal adenopathy was also present. Histological examination showed foci of metastatic adenocarcinoma in the superficial and middle dermis; microscopic findings consistent with radiation dermatitis were also evident. This particular case presented with some uncommon features. Firstly, the skin metastases from rectal adenocarcinoma involved the genital region, which is considered a rare finding. Also, the clinical presentation was quite impressive. The localization of the cutaneous metastases was in an area of radiation dermatitis corresponding to the portal of prior irradiation. Although the occurrence of metastases in an area of previous irradiation is relatively rare, the physician should be aware of this possibility. Irradiation, however, is not expected to increase the probability of metastasis at the radiation port, and the role of adjuvant radiation therapy in combined treatment regimens to improve local control and/or survival in cancer patients remains well-established.

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