Metastatic Cutaneous Carcinoid

The cutaneous manifestations of the carcinoid syndrome have been described by Ritchie1and Kierland et al.2Flushing, of variable duration and intensity, involving the face, neck, chest, and shoulders, is characteristic of the syndrome. Microscopic examination of the involved skin shows dilatation and congestion of veins and capillaries, at times thickening of vessel walls, including arterioles, edema and chronic inflammation. Shafer, in a discussion of Kierland's article, disclosed that of 261 carcinoids reviewed by Helwig and Manion of the Armed Forces Institute of Pathology, there were 6 cases of the functioning carcinoid syndrome. Sections from the skin in 2 of these patients showed slight ectasia with minimal infiltration. Zarafonetis et al.3noted that fibrotic changes may be induced in the skin and elsewhere by functioning carcinoids. In the cases of carcinoids previously reported, metastatic cutaneous lesions were rarely encountered. Walker,4in reviewing malignant carcinoids (argentaffinomas) with