Cutaneous metastasis as the first sign of lung cancer

Cutaneous metastases of lung tumors are occurring in 1-12% of cases. High prevalence of lung cancer increases the likelihood of finding these changes in clinical practice. They are usually in the form of a firm, mobile and painless nodule on the head, neck and chest, and their appearance is a sign of advanced disease. Cutaneous metastases are rarely the first sign of malignancy. A 62-year-old patient presented to her doctor a fast-growing nodule on the forehead. Extirpation of the nodule and further diagnosis showed that it was a metastasis of small cell lung cancer localized in the right lung with extensive metastases to the contralateral lung, liver and spine. Cutaneous metastases may be the first sign of malignancy or the first sign of progression of already diagnosed malignancy. A diagnosis of metastatic disease should be considered in patients with risk factors or a known cancer. The presence of a skin metastasis in a patient with a lung cancer indicates poor prognosis.