Osteogenic sarcoma with skin metastases

Skin metastasis from solid tumors is uncommon. Several series have reported the frequency to be 0.7% to 9.0%.lm6 A recent large series reported an incidence of approximately lO%.7 This disparity is probably due to several factors. First, an autopsy commonly exposes greater numbers and sites of metastasis than the premortem examination. Second, reports with greater (or lesser) numbers of women may have differing results because breast cancer is common and is frequently associated with cutaneous metastases. Similarly, the tumor types included in the analysis alter the reported incidence of distant skin involvement. Melanoma, for example, commonly metastasizes to skin. The most frequent noncutaneous olid tumors implicated are tumors of breast, lung, and colon. Osteogenic sarcoma is the most common primary malignancy of bone in children and adolescents.* The mode of metastasis is mainly hematogenous; the most frequently involved organs are the lung and distant bone. Regional lymph node metastasis occurs in approximately 10% of patients.g Osteosarcoma with metastasis to skin is rare, and to our knowledge this phenomenon has been seldom reported. We describe a patient treated with radiation for Hodgkin’s disease in whom a right clavicular osteosarcoma with multiple skin metastases later developed.