Gastrointestinal cancer skin metastases
Introduction
Introduction to skin metastasis of gastrointestinal cancer Gastrointestinal cancer, colon and rectal cancer is the second most common primary tumor, and is the most common visceral tumor that metastasizes to the skin. Most occur in the rectum, accounting for 11% to 19% of male skin metastatic cancer, and 1.3% to 9% of women. Colorectal cancer is usually found before skin metastasis, and the site of skin metastases, usually from the gastrointestinal tract, is the abdominal wall, perineum, and umbilicus. basic knowledge Sickness ratio: 0.001%-0.002% Susceptible people: no special people Mode of infection: non-infectious complication:
Cause
Gastrointestinal cancer skin metastasis
(1) Causes of the disease
The cause is still unknown.
(two) pathogenesis
The pathogenesis is still unclear.
Prevention
Gastrointestinal cancer skin metastasis prevention
Actively prevent primary gastrointestinal cancer.
Complication
Gastrointestinal cancer skin metastasis complications Complication
Common metastatic pathways include lymphatic metastasis, vascular metastasis, and implantative metastasis. Once the cancer cells invade the lymphatic vessels, they can fall off to form emboli, or proliferate in the tube to form a continuous mass, but most of them enter the regional lymph nodes through the lymphatic vessels to form intralymphatic metastasis. The earlier the lymph node metastasis occurs, the wider the range may be. Hematogenous metastasis may occur when lymphocytes containing cancer cells enter the bloodstream (along the thoracic duct), or if the cancer cells directly invade small blood vessels. Cancer cells entering the blood move in the bloodstream in the form of a single cell or a bundle of cellulose. Cancer cells that normally enter the blood circulation cannot survive, but when they get a chance to stay during the operation, they will invade the wall and enter the interstitial around the blood vessels and grow into metastases. Anticoagulants and chemotherapy have the potential to reduce tumor metastasis, while extrusion and local manipulation may increase the chance of metastasis. Different tissues of the body have different affinities for metastasis. Liver, lung, bone marrow, brain and adrenal glands are common metastatic sites, while spleen and muscle are rarely metastasized. Generally, blood transfer occurs in the later stages of the disease, but lung cancer, breast cancer, kidney cancer, prostate cancer, and thyroid cancer can have blood transfer in the early stage.
Common tumor metastasis sites are lung, liver, bone, brain, and the like. Metastatic cancer is not necessarily the late stage of cancer, and some cancers can also metastasize early.
Symptom
Gastrointestinal cancer skin metastasis symptoms Common symptoms Nodular skin metastasis inflammatory cell infiltration non-sweat gland ductal keratin... Inflammatory damage
Colon and rectal skin metastases are flesh-colored pedicle or drape nodules, inflammatory cancer, clusters of vascular nodules, or occasionally perianal nodules and inflammatory lesions suggesting suppurative sweat glands, stomach, pancreas and gallbladder When a cancer is transferred to the skin, it usually presents with nodular and scleroderma-like plaques.
Examine
Gastrointestinal cancer skin metastasis examination
Histopathology: The metastatic carcinoma of the skin from the large intestine is mainly secreted secretory mucin-secreting adenocarcinoma. In some cases, it is the appearance of mucinous carcinoma. The skin metastasis is less common in poorly differentiated cells. Therefore, it is difficult to recognize that it is the epithelial origin. The metastatic carcinoma of the skin from the stomach is often an anaplastic invasive carcinoma, and the number of indwelling cells containing intracellular mucin is in a loose or fibrous matrix.
Special staining and immunohistochemistry: Gastrointestinal adenocarcinoma contains sputum mucins including neutral and non-sulfate mucopolysaccharides, PAS-positive and amylase-resistant, tumor cells positive for cytokeratin and carcinoembryonic antigen, but huge cystic disease liquid protein -15 (GCDFP-15), prostate specific antigen (PSA) or prostatic acid phosphatase (PAP) negative.
Diagnosis
Diagnosis and differential diagnosis of gastrointestinal cancer skin metastasis
According to clinical manifestations, the characteristics of skin lesions and histopathological features can be diagnosed. The following points should be noted.
1. Clinically short-term (6 to 12 months) rapid growth of tumor nodules, distributed in the vicinity of the primary tumor surgery area or the corresponding lymphatic drainage area, and its histopathological morphology is similar to the primary tumor, especially When it is characterized by multiple or multifocal tumors, it should be considered as metastatic cancer of the skin.
2. Tumor plugs are found in the skin or subcutaneous fat vessels or lymphatic vessels. The distribution configuration of the cancer is narrow and trapezoidal at the bottom, generally not connected with the epidermis, there is very little inflammatory cell infiltration around the tumor cells, and no sweat gland ductal keratin membrane Differentiation, etc., are often characteristic of metastatic skin tumors.
3. By immunohistochemical labeling, it is helpful to distinguish, for example, GCDFP-15, which is primary in the sweat gland-derived tumor, and PSA and TG positive in the prostate and thyroid metastasis to the skin, respectively. In addition, the metastatic skin knot in the umbilical cord Except for endometriosis or implanted nodules, it should also be distinguished from yolk sac or urachal embryo residues.
Should be identified with suppurative sweat gland inflammation, scleroderma.
