MUCOCUTANEOUS SIGNS OF SYSTEMIC CANCERS ICD-10: M8000/6
Mucocutaneous findings may suggest systemic cancers in several ways:
Associations of heritable mucocutaneous disorders with systemic cancers.
By action at a distance, i.e., paraneoplastic syndromes.
Or spread of cancer to the skin or mucosal sites by direct, lymphatic, or hematogenous extension (cutaneous metastasis).
CLASSIFICATION OF SKIN SIGNS OF SYSTEMIC CANCER
PERSISTENT TUMOR Lymphatic extension and hematogenous spread1.
DIRECT EXTENSION Paget disease and extramammary Paget disease.
Lymphomas with secondary skin involvement (Section 21).
Neurofibromatosis (see Section 16).
Tuberous sclerosis (see Section 16).
Multiple endocrine neoplasia (types 1 and 2b).
Acanthosis nigricans, malignant, tripe palms
Paraneoplastic pemphigus (paraneoplastic autoimmune multiorgan syndrome)
METASTATIC CANCER TO THE SKIN ICD-10: M8000/6
Metastatic cancer to the skin is characterized by solitary or multiple dermal or subcutaneous nodules, occurring as metastatic cells from a distant noncontiguous primary malignant neoplasm*.
They are transported to and deposited in the skin or subcutaneous tissue by one of the following routes:
Skin lesions nodule (Figs. 19-1 and 19-2), raised plaque, thickened fibrotic area. First detected when <5 mm. The fibrotic area may resemble morphea; occurring on scalp, may produce alopecia. Initially, epidermis is intact and stretched over nodule; in time, the surface may become ulcerated (Fig. 19-3) or hyperkeratotic. It may appear inflammatory, i.e., pink to red or hemorrhagic. Firm to indurated. May be solitary, few, or multiple. May acquire considerable size and may be mistaken for a primary skin cancer (Fig. 19-3).
Metastatic cancer to the skin: bronchogenic cancer Dermal nodules on the scalp of a patient undergoing chemotherapy for metastatic lung cancer; the nodules were only apparent following loss of hair during chemotherapy. The nodule on the left is asymptomatic, erythematous, but noninflamed. The nodule on the right has a central depression marking a punch biopsy site.