Background: Cutaneous metastasis of colorectal cancer is rare, especially to the scalp.
Methods: Our patient is a seventy-one year old gentleman who had a pT3N1M1 adenocarcinoma of the caecum with gastrocolic deposits. He was treated with right extended hemicolectomy, resection of deposits and adjuvant chemotherapy. At time of surgery he was noted to have what appeared clinically as an infected sebaceous cyst on the scalp. Following excision of this lesion, the histology report demonstrated a dermal deposit of metastatic carcinoma consisted with the primary colorectal tumour. He was referred to plastic surgery service for wide local excision and split thickness skin graft. At which point, the deposit had grown to a sixty-five millimetre exophytic mass.
Results: From our review of the literature, only 14 cases of colorectal metastasis to scalp have been reported. Two further cases of oesophageal metastasis were also published.
Conclusion: This is a rare presentation of metastatic disease from colorectal adenocarcinoma. Yet it is an important prognostic factor, relevant in determining adjuvant treatment. It’s appearance may be mistaken for other skin pathologies which are more common in the scalp.
Ciara Walsh1, Rachel Enright1, Anthony James Clover1
1 Plastic Surgery Department, Cork University Hospital, Cork