Cutaneous metastatic lesion as a presentation of rectal cancer: A case report

Introduction: Colorectal cancer is ranked third among the most commonly diagnosed malignancies and second among the leading causes of cancer death in the world. However, only a few case reports are found in the literature regarding skin metastases originating from rectal cancer, which usually shows widespread disease and poor prognosis. Case Report: A 68-year-old female patient presented with anterior chest wall pain and swelling and a history of progressive growing of the lesion for the last five months. Physical examination revealed a palpable 3 cm mass in the intermammillary area with mild inflammation of the surrounding skin. The lesion biopsy revealed moderately differentiated intestinal-type adenocarcinoma, suggesting metastasis of a colorectal primary cancer. Colonoscopy revealed an obstructive neoplasm of the rectum located 12 cm from the anal verge. Histology revealed a moderately differentiated adenocarcinoma as seen before in the skin lesion. The computed tomography (CT) scan also detected several secondary lesions on the liver. Conclusion: Approximately 0.8% of the patients present with a skin lesion as the first indication of a silent internal malignancy, which is rare and carries a poor prognosis. Cutaneous metastases are considered as an advanced presentation of colorectal cancer, mostly managed with palliative care.