Cutaneous Metastases From Carcinoma of the Colon

To the Editor.— Cutaneous metastases from carcinoma of the colon are relatively uncommon, having been reported in less than 4% of patients with colonic cancer coming to autopsy.1,2When this type of metastasis does appear, however, it may be the first evidence of tumor spread,3,4and thus warn the clinician. Since the gross appearance of these metastases is not distinctive,3early biopsy is most important. We have recently treated two patients with adenocarcinoma of the colon in whom the first manifestation of tumor spread was the appearance of rather striking skin metastases. In both cases, delay between the appearance of the skin lesions and the recognition (by biopsy) of their true nature lost the opportunity to institute further therapy while the tumor mass was still small. The first patient had extensive metastases to the hands 4 1/2 years after the removal of the primary tumor, while the