Facial Cutaneous Metastases of Gastric Signet-ring Cell Carcinoma: Resection and Reconstruction as a Palliative Surgical Treatment Option.

Background: Cutaneous metastases of gastric signet-ring cell gastric carcinoma are very rare. Our following case report highlights the need for careful clinical examination and skin biopsy of newly developing scar-like or erythematous skin lesions in patients with a known history of malignant disease in order to prevent diagnostic and therapeutic delay.

Case Report: A 68-year-old male patient presented with two slightly painful, erythematous, facial skin lesions (chin and forehead) 2 years after gastrectomy for a signet-ring cell gastric carcinoma. The patient complained of intermittent neuropathic pain in the area of the mental nerve. A biopsy of both skin lesions demonstrated metastasis of signet-ring cell gastric carcinoma. Following discussion within the multidisciplinary tumor board, palliative surgical excision was recommended for this patient. Both skin lesions were resected and the large defect in the chin region was primarily closed by a cervical skin transposition flap.

Conclusion: The presented case report of a patient with a known history of malignancy illustrates that newly developing erythematous skin lesions may be suspicious for cutaneous metastases. Palliative surgical interventions may play a role even in an advanced disease stage.