Inflammatory cutaneous metastasis from laryngeal carcinoma

The authors report the case of a 64-year-old man who presented with erythematous infiltrating plaques sited on his right supraclavicular and infraclavicular regions. Five years before a laryngeal epidermoid carcinoma had been surgically removed. After two years the patient underwent lymphadenectomy and radiotherapy for the presence of metastasis in his right cervical lymph nodes. He was disease free until two months before our examination when small red spots appeared on his right supraclavicular region, slightly enlarging. A skin biopsy was performed and histological examination showed the presence of metastatic cells inside dilated lymphatic vessels. Immunohistochemical markers showed only positive staining of atypical cells with monoclonal anti-cytokeratin antibodies (cytokeratin B-ORTHO=34betaE12) confirming the epithelial origin of metastastic cells. A diagnosis of inflammatory cutaneous metastasis from laryngeal epidermoid carcinoma was given. This type of metastasis has been frequently observed in patients with breast carcinoma and it has also been described during the course of other malignant tumours. Malignant tumour of the larynx generally spreads to regional lymph nodes or, through blood, to the lungs. Skin metastasis have rarely been described, and always as multiple or solitary nodules. According to our knowledge this is the first case of inflammatory cutaneous metastasis from laryngeal epidermoid carcinoma reported in the literature.