Advanced gastroesophageal junction adenocarcinoma with skin involvement: a multidisciplinary perspective

Background Skin metastasis secondary to visceral malignancy is a rare but poor prognostic occurrence. We report a rare case of gastroesophageal junction (GEJ) adenocarcinoma with skin metastases, highlighting the challenges in managing such cases. Case Presentation A 63-year-old male diagnosed with stage IV Siewert 3 GEJ adenocarcinoma with initial extensive skin metastases. Palliative radiation and four cycles of first-line FOLFOX resulted in progression and new skin lesions. A second-line FOLFIRI and third-lines taxane regimens failed to yield clinical improvement and stop progression. His disease worsened with widespread metastases including omentum and peritoneum. He died 9 months after initial presentation due to intestinal perforation secondary to neutropenic fever. Conclusion Skin metastases from GEJ adenocarcinoma are associated with aggressive disease chemotherapy resistance. A multidisciplinary approach, palliative care, and novel strategies are essential for managing such cases.