International Journal of Head and Neck Surgery

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VOLUME 6 , ISSUE 2 ( April-June, 2015 ) > List of Articles


Cutaneous Metastasis of Head and Neck Malignancy

Henry Emanuel, Patrick Emanuel

Citation Information : Emanuel H, Emanuel P. Cutaneous Metastasis of Head and Neck Malignancy. Int J Head Neck Surg 2015; 6 (2):57-63.

DOI: 10.5005/jp-journals-10001-1223

Published Online: 01-06-2016

Copyright Statement:  Copyright © 2015; The Author(s).



Noncutaneous cancers of the head and neck occasionally metastasize to skin. We present a case series of patients with skin metastases from non-cutaneous malignancies of the head and neck. A literature review is presented to assess the morphology, pattern of distribution, and morbidity of skin metastases.


Relevant cases were identified by a dermatopathologist and cases were reviewed. A literature search yielded 94 cases which were also included.


The most common primary site, histology, and location of spread was the thyroid gland (42%), squamous cell carcinoma (42%), and scalp (25%) respectively. Skin metastases typically present as a discrete nodules, but the distribution varies. Metastases to skin can occasionally be a patients presenting complaint, but irrespective of timing of presentation portend a poor prognosis.


Skin metastases are clinically rare, and when present typically herald a poor overall prognosis. Information regarding their distribution and clinical presentation is of importance to the surgeon and oncologist.

How to cite this article

Emanuel H, Emanuel P. Cutaneous Metastasis of Head and Neck Malignancy. Int J Head Neck Surg 2015;6(2):57-63.

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  1. Skin metastasis: a pathologist's perspective. J Cutan Pathol 2009.
  2. Skin involvement as the presenting sign of internal carcinoma: a retrospective study of 7316 cancer patients. J Am Acad Dermatol 1990; 22(1):19-26.
  3. Spread of tumors to the skin. Arch Dermatol 1973;107(1):80-86.
  4. Skin metastases from head and neck squamous cell carcinoma: incidence and impact. Head Neck 1999;21(6):560-555.
  5. Cutaneous metastases in head and neck cancer. Radiation Oncology Investigations 1996;4(4):176-184.
  6. Skin metastases in squamous cell carcinoma of the head and neck. Otolaryngol Head Neck Surg 2001;124(3):248-252.
  7. Cutaneous metastases from follicular thyroid carcinoma: histology, immunohistology, and electron microscopy—a report of two cases. Dermatologica 1991;183(4):286-289.
  8. Malignant mixed tumour arising from minor salivary gland tissue of the right parapharyngeal space with metastasis to the scalp. Ann Acad Med Singapore 1992;21(3):382-385.
  9. Cutaneous metastasis from follicular carcinoma of the thyroid gland. Thyroid 1993;3(3):235-237.
  10. Solitary skin metastasis as the presenting feature of differentiated thyroid microcarcinoma: report of two cases. J Endocrinol Invest 1995;18(10):813-816.
  11. Malignant pleomorphic parotid adenoma with inflammatory cutaneous metastasis. Br J Dermatol 1996;134(1):190-192.
  12. Papillary and follicular thyroid carcinoma metastatic to the skin: a case report and review of the literature. Thyroid 1998;8(11):1045-1050.
  13. Cutaneous metastasis from a parotid adenoid cystic carcinoma arising in a pleomorphic adenoma. J Otolaryngol 1999;28(3):166-170.
  14. Nasal tip metastasis of pharyngeal rhabdomyosarcoma. Ann Plast Surg 2001;46(6):656.
  15. Scalp and intracranial metastasis from pleomorphic adenocarcinoma of the parotid gland. Neurol India 2007;55(4):433-434.
  16. Cutaneous metastasis from follicular variant of papillary thyroid carcinoma: a case diagnosed on cytology. Ind J Pathol Microbiol 2008;51(1):91-93.
  17. Patterns of cutaneous metastasis. Arch Dermatol 1972;105(6):862-868.
  18. Cancer 1972;29(5):1298-1307.
  19. Needle tract implantation of papillary carcinoma of the thyroid following aspiration biopsy. Acta Cytol 1990;34(6):801-804.
  20. Cutaneous seeding of a follicular thyroid cancer after fine-needle aspiration biopsy? Diagn Cytopathol 1994;10(2):156-158.
  21. Implantation metastasis of head and neck cancer after fine needle aspiration biopsy. Auris Nasus Larynx 2001;28(4):377-380.
  22. Needle track seeding of papillary thyroid carcinoma from fine needle aspiration biopsy: a case report. Acta Cytol 2002;46(3):591-595.
  23. Anaplastic thyroid carcinoma implantation after fine needle aspiration cytology. J Laryngol Otol 2007;121(3):268-270.
  24. Needle track dissemination of follicular thyroid carcinoma following fine-needle aspiration biopsy: report of a case. Surg Today 2007;37(1):34-37.
  25. Skin and thigh muscle metastasis from papillary thyroid cancer. Singapore Med J 2009;50(2):e61–e64.
  26. Anaplastic thyroid carcinoma metastatic to skin. J Cutan Pathol 1974;1(5):201-206.
  27. Dermal metastases from a follicular carcinoma of the thyroid. Arch Dermatol 1977;113(5):675-676.
  28. Cutaneous metastasis of a radiation-associated thyroid medullary carcinoma. J Endocrinol Invest 1984;7(6):653-657.
  29. Cutaneous metastasis from papillary carcinoma of the thyroid gland: report of two cases. J Am Acad Dermatol 1984;10(6):988-992.
  30. Medullary carcinoma of the thyroid metastatic to the skin: report of two cases. J Cutan Pathol 1987;14(4):251-254.
  31. Cutaneous metastasis from papillary carcinoma of the thyroid: a case confirmed by monoclonal antithyroglobulin antibody. Dermatologica 1988;177(4):241-243.
  32. Cutaneous metastasis from papillary carcinoma of the thyroid gland. J Am Acad Dermatol 1991;25(2 Pt 2):404-408.
  33. A case of skin metastasis from follicular thyroid carcinoma. Dermatology 1994;188(1):69-71.
  34. Cutaneous metastases from anaplastic thyroid carcinoma. Int J Dermatol 1996;35(8):574-575.
  35. Thyroid carcinoma metastatic to the skin: a cutaneous manifestation of a widely disseminated malignancy. J Am Acad Dermatol 1997;36(4):531-537.
  36. An unusual case of papillary carcinoma of the thyroid with cutaneous and breast metastases only. Eur J Endocrinol 1997;137(3):267-269.
  37. Follicular carcinoma of thyroid gland presenting as scalp metastasis. Acta Cytol 1998;42(2):451-452.
  38. Cutaneous metastasis revealing a widely disseminated follicular thyroid carcinoma. Clin Nucl Med 2002;27(5):379-380.
  39. Cutaneous metastasis from medullary carcinoma of thyroid gland. Clin Exp Dermatol 2003;28(6):670-671.
  40. Cutaneous nodes in a patient with advanced papillary carcinoma of the thyroid. Clin Transl Oncol 2006;8(9):692-693.
  41. Skin metastases from anaplastic thyroid carcinoma. Thyroid 2006;16(5):513-514.
  42. Papillary thyroid cancer with metastasis to the skin. Clin Nucl Med 2006;31(7):435-436.
  43. Papuloerythematous rash due to intralymphatic cutaneous metastasis of cancer. Intern Med 2006;45(2):115-116.
  44. Solitary skin metastasis from papillary thyroid carcinoma. Thyroid 2007;17(5):477-478.
  45. Follicular thyroid carcinoma with metastasis to skin diagnosed by fine needle aspiration cytology. Ind J Pathol Microbiol 2008;51(3):430-431.
  46. Papillary thyroid carcinoma with an uncommon spread of hematogenous metastases to the choroid and the skin. J Natl Med Assoc 2008;100(1):104-107.
  47. Four patients with cutaneous metastases from medullary thyroid cancer. Thyroid 2008;18(8):901-905.
  48. Cutaneous metastasis of thyroid cancer presenting as a nodulocystic mass with ulceration. J Dermatol 2009;36(10):559-560.
  49. Solitary cutaneous metastasis as the first sign of relapse of thyroid carcinoma: a clinical, dermoscopicpathologic case study. Dermatol Surg 2009;35(3):523-526.
  50. Prognostic factors for thyroid carcinoma: a population-based study of 15,698 cases from the surveillance, epidemiology and end results (SEER) program 1973-1991 Cancer 1997;79(3):564-573.
  51. Mucoepidermoid carcinoma metastatic to the skin: an histologic mimic of a primary sweat gland carcinoma. J Dermatol Surg Oncol 1992;18(5):365-368.
  52. Orbital and skin metastases in a polymorphous low grade adenocarcinoma of the salivary gland. J Laryngol Otol 1995;109(12):1222-1225.
  53. Cutaneous metastasis from a parotid adenocarcinoma. Report of a case with immunohistochemical findings and review of the literature. Am J Dermatopathol 1995;17(3):303-306.
  54. Cutaneous metastasis from an adenoid cystic carcinoma of the lacrimal gland. Br J Dermatol 1999;141(2):373-374.
  55. Primary high-grade mucoepidermoid carcinoma of the minor salivary glands with cutaneous metastases at diagnosis. Oral Oncology 2002;38(4):401-404.
  56. Cutaneous metastasis from adenoid cystic carcinoma of the parotid gland. Dermatol Surg 2003;29(7):775-779.
  57. Cutaneous metastasis: a clinical, pathological, and immunohistochemical appraisal. J Cutan Pathol 2004;31(6):419-430.
  58. Multiple cutaneous metastases from a parotid adenoid cystic carcinoma. Pathol Oncol Res 2007;13(2):167-169.
  59. Widespread cutaneous metastases from acinic cell carcinoma 20 years after primary presentation. J Cutan Pathol 2008;35(6):591-593.
  60. Unusual recurrence after chemoirradiation and surgery for squamous cell carcinoma of the tongue. Asian J Surg 2002;25(1):62-65.
  61. Skin and eye: uncommon sites of distant metastasis from tongue base squamous cell carcinoma. Acta Otolaryngol 2003;123(9):1110-1114.
  62. Head and neck squamous cell carcinoma skin metastases below of the diaphragm. Acta Dermatovenerol Croat 2003;11(3):153-157.
  63. Prognostic significance of skin involvement from mucosal tumors of the head and neck. Arch Otolaryngol Head Neck Surg 1995;121(11):1246-1248.
  64. Dermal metastases in epidermoid carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg 1993;119(3):326-330.
  65. Cutaneous metastases from laryngeal carcinoma. J Dermatol Surg Oncol 1988;14(5):562-564.
  66. Tagami skin metastasis in laryngeal carcinoma. Clin Exp Dermatol 1992;17(4):282-283.
  67. Inflammatory cutaneous metastasis from laryngeal carcinoma. Eur J Dermatol 2001;11(2):124-126.
  68. Cutaneous metastasis of neuroendocrine carcinoma of the larynx: report of a case. J Cutan Pathol 2003; 30(8):512-515.
  69. Skin metastasis: an unusual localization from laryngeal carcinoma. Kulak Burun Bogaz Ihtis Derg 2004;12 (3-4):103-106.
  70. Painful cutaneous metastasis in a patient with laryngeal adenocarcinoma. Clin Exp Dermatol 2007;32(2):225-226.
  71. A rare nasal tip skin metastasis of a basaloid squamous cell carcinoma of the larynx. Am J Med 2008;121(9):e3–e4.
  72. Long-term survival rates of laryngeal cancer patients treated by radiation and surgery, radiation alone, and surgery alone: studied by lognormal and Kaplan-Meier survival methods. BMC Cancer 2005;5:13.
  73. Carcinoma erysipelatoides-cutaneous lymphatic vessel spread of a poorly differentiated nasopharyngeal carcinoma. Dermatol Online J 2001;7(2):7.
  74. Skin metastasis from nasopharyngeal carcinoma in four Chinese patients. Clin Exp Dermatol 2004; 29(1):28-31.
  75. Nasopharyngeal carcinoma with extensive nodular skin metastases: a case report. Tumori 2006;92(2): 181-184.
  76. Axillary and subcutaneous breast metastases from rhinopharyngeal carcinoma: a case report and literature review. Anticancer Res 2008;28(1B):419-423.
  77. Prognostic factors for mortality in nasopharyngeal cancer: accounting for time-dependence of relative risks. Int J Epidemiol 1998;27(5):772-780.
  78. Hypopharyngeal squamous cell carcinoma metastatic to skin. JAm Acad Dermatol 1985;12(1 Pt 2):169-172.
  79. Metastatic hypopharyngeal carcinoma mimicking necrotizing vasculitis of the skin. Cutis 1992;49(3):187-188.
  80. Cutaneous metastasis from carcinoma of tonsil. J Postgrad Med 2002;48(1):32-33.
  81. Epidermotropic cutaneous metastases from hypopharyngeal carcinoma. J Otolaryngology 2004;33(3): 198-200.
  82. Cutaneous metastases from a hypopharyngeal malignancy. J Laryngology and Otology 2005; 119(4):319-321.
  83. Skin metastasis of head and neck carcinoma predictive for dismal outcome. Dermatol Online J 2008;14(6):8.
  84. Delayed regional metastases, distant metastases, and second primary malignancies in squamous cell carcinomas of the larynx and hypopharynx. Laryngoscope 2001;111(6):1079-1087.
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