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Atypical Carcinoid Metastasis to the Skin

Blochin, Elen MD, PhD; Stein, Jennifer A MD, PhD; Wang, Nadia S MD

American Journal of Dermatopathology: October 2010 - Volume 32 - Issue 7 - pp 735-739
doi: 10.1097/DAD.0b013e3181d4d0fb
Extraordinary Case Report

Carcinoid tumors are derived from neuroendocrine cells, and are most frequently found in the gastrointestinal tract and bronchopulmonary system. Cutaneous involvement of carcinoid tumors is relatively rare, with isolated case reports in the literature. We detail a patient with stage IV pulmonary atypical carcinoid tumor with skin metastasis. This case is unusual because the patient did not have any erythema or induration of the scalp, only a complaint of pain. On biopsy, the tumor cells had cytologic features of a carcinoid tumor, but were arranged as infiltrating cords, small aggregates and single units, rather than the organoid or trabecular pattern seen in the primary tumor. Further, along with neuroendocrine markers, the tumor cells had the staining pattern of cytokeratin 7+/cytokeratin 20−/thyroid transcription factor-1+, supporting a carcinoid tumor of lung origin. Thus, this case of skin metastasis from an atypical pulmonary carcinoid tumor illustrates a unique clinical and histologic presentation.

From Section of Dermatopathology, Department of Dermatology, New York University School of Medicine, New York, NY.

Conflicts of interest: None declared.

Funding sources: Irwin I. Lubowe Fellowship in Dermatology (JAS).

Reprints: Nadia S. Wang, MD, Section of Dermatopathology, New York University School of Medicine, 530 First Avenue, Suite 7J, New York, NY 10016 (e-mail: nadiaswang@hotmail.com).

© 2010 Lippincott Williams & Wilkins, Inc.