Background: Cutaneous metastasis (CM) is the spread of cancer cells from a primary site to the skin and is rarely the first sign of silent cancer. We investigated the clinicopathological characteristics of CM from internal malignancies in Korean patients treated at our institution over 20 years. Methods: The clinicopathological findings of 112 patients (62 females, 50 males) with CM diagnosed at Yeungnam University Hospital between 2000 and 2020 were retrospectively reviewed. Results: Mean patient age was 58.6 years (range, 26 to 87 years), and the most common primary cancer site was breast (74.2%) in women and lung (36.0%) in men. Ninety-six patients (85.7%) presented with CM after primary tumor diagnosis. CM from the lung or biliary tract usually occurred within 2 years of primary tumor diagnosis, whereas metastases from the breast and kidney occurred several years later. The chest, abdomen, and scalp were common sites of CM. Breast cancer usually metastasized to chest skin, while gastrointestinal tract cancers commonly metastasized to the abdomen. The scalp was a common location for CM from various tumors. The most common dermatologic presentations were nodules and masses. Immunohistochemical studies helped identify underlying malignancies when primary tumors were unknown. Conclusions The relative frequency of CM parallels the overall incidence of primary malignant tumors, and CMs usually occur at anatomic sites close to the primary tumor. CM can be diagnosed based on clinical, radiological, and histological features; however, immunohistochemical study is required in some cases.

Background: Nodular hidradenoma is a relatively common benign cutaneous neoplasm, which usually presents as solitary intradermal nodule. In Korea, an extensive study on tumors with eccrine differentiation was performed in 2006; however, the study considered all eccrine tumors and detailed analysis of its differentiation was not performed. In addition, although most skin pathology textbooks classify it as a tumor showing eccrine differentiation, its differentiation remains controversial. Objective: This study investigated clinicopathological features of nodular hidradenoma in Koreans at a tertiary referral center. Methods: We retrospectively investigated 22 patients who presented with nodular hidradenoma at Yeungnam University Hospital between 2000 and 2021. Diagnosis was confirmed by histopathological examination in all the patients. Results: About half of the lesions were located on the head and neck area (45.5%), followed by the trunk (31.8%). Histopathological examination revealed that tumor cells in most of the cases consisted of cuboidal and clear cells; however, in some cases there were several specific modified cells such as clear cells (9.1%), squamoid cells (4.5%), and poroid cells (22.7%). Considering the morphological characteristic of tubular structures, most cases (90.9%) showed apocrine differentiation, and only 2 cases (9.1%) showed eccrine differentiation. Conclusion Considering the characteristics of cells and tubular structures constituting tumors, it is reasonable to consider nodular hidradenoma as a tumor with apocrine differentiation rather than with eccrine differentiation, which had previously been the predominant classification. Furthermore, there still is no distinct marker for determining whether cells differentiate into eccrine or apocrine tissues and further studies are therefore needed.

Background: Cutaneous metastasis (CM) is the spread of cancer cells from a primary site to the skin and is rarely the first sign of silent cancer. We investigated the clinicopathological characteristics of CM from internal malignancies in Korean patients treated at our institution over 20 years. Methods: The clinicopathological findings of 112 patients (62 females, 50 males) with CM diagnosed at Yeungnam University Hospital between 2000 and 2020 were retrospectively reviewed. Results: Mean patient age was 58.6 years (range, 26 to 87 years), and the most common primary cancer site was breast (74.2%) in women and lung (36.0%) in men. Ninety-six patients (85.7%) presented with CM after primary tumor diagnosis. CM from the lung or biliary tract usually occurred within 2 years of primary tumor diagnosis, whereas metastases from the breast and kidney occurred several years later. The chest, abdomen, and scalp were common sites of CM. Breast cancer usually metastasized to chest skin, while gastrointestinal tract cancers commonly metastasized to the abdomen. The scalp was a common location for CM from various tumors. The most common dermatologic presentations were nodules and masses. Immunohistochemical studies helped identify underlying malignancies when primary tumors were unknown. Conclusions The relative frequency of CM parallels the overall incidence of primary malignant tumors, and CMs usually occur at anatomic sites close to the primary tumor. CM can be diagnosed based on clinical, radiological, and histological features; however, immunohistochemical study is required in some cases.

Syphilis is a highly contagious sexually transmitted disease, and early diagnosis and prompt treatment significantly affect the prognosis. Syphilis usually presents with genital lesions in the early stages; therefore, extragenital syphilitic lesions can easily be misdiagnosed. A 20-year-old man presented with a 1-month history of a worsening hyperkeratotic black crusted ulcerative plaque on the right 4 th finger, with distorted periungual structures.Histopathological examination showed epidermal hyperplasia, mild endothelial swelling, and numerous plasma cells in the dermis. Excessive dermal infiltration of plasma cells suggested primary syphilis, which necessitated additional serological tests; the patient showed positive results on Venereal Disease Research Laboratory and Treponema pallidum hemagglutination testing. The lesion significantly improved after an intramuscular injection of 2.4 million units of benzathine penicillin G. We report a rare case of primary syphilis involving the finger in a patient with clinical features of ulcerative paronychia.

OBJECTIVE: To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. MATERIALS AND METHODS: Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. RESULTS: The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL +/- 6.8 before stent insertion, decreased to 4.58 mg/dL +/- 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 +/- 99 days, and the median patient survival was 179 +/- 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). CONCLUSION: Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.
Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms/complications/secondary/*surgery ; Bile Ducts, Extrahepatic/*surgery ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Jaundice, Obstructive/diagnosis/etiology/*surgery ; Male ; Middle Aged ; Prosthesis Design ; Retrospective Studies ; *Stents ; Stomach Neoplasms/*complications/secondary/surgery ; Treatment Outcome