Unusual sites of metastases.

Unusual metastases occur in a significant percentage of patients with malignant disease. In large measure, they represent a preterminal event. This is not always the case, however. In patients who have metastases to the skin, the event is generally preterminal particularly when the primary is the lung. In that instance the time between appearance of the metastasis and death is between 1.5 and 2.6 mo. Metastases to the skin occurring in patients with carcinoma of the cervix also represents a preterminal event with a time from diagnosis to death of 3 mo. In patients with carcinoma of the esophagus, the time from diagnosis to death is 4.3 mo, on the average. On the other hand, metastases to the skin from primary malignant tumors involving the colon, bladder, kidney, and ovary do not represent preterminal events. The time form diagnosis to death varies from 7.3 mo in carcinoma of the ovary to 12.7 mo in carcinomas of the kidney. Therefore, it is important when a patient presents with metastases to the skin to establish the primary source, the extent of the metastatic lesions and devise treatment programs that are appropriate to the pattern of the metastasis and the primary diagnosis...