Abstract：
BACKGROUND: Our patient presents with a novel presentation of a fungated ulcerated skin lesion as the initial presentation of lung cancer. The literature describes skin metastases from lung cancer as nodular, papular, and zosteriform. Our case is a fungating ulcerated skin lesion which is not widely reported in literature. There is a still a need for more data on the clinical presentation and prognosis of such cases as it will elucidate the diagnostic challenges and treatment management.
METHODS: We present a case of a 55 year old Caucasian male with a 60-pack-year smoking history initially presenting with a nodule on his right upper back that quickly fungated and ulcerated requiring surgical excision. Biopsy of both the skin lesion and the lung mass confirmed squamous cell carcinoma (SCC) and the lung mass being the primary tumor. The patient\'s clinical and functional status severely declined during his hospital stay and was later discharged to hospice without therapeutic intervention. He later expired a month after hospice stay.
CONCLUSIONS: Although uncommon, this case clearly illustrates that skin metastases can be the initial finding of primary lung cancer and that not all patients with lung cancer will present with bronchopulmonary symptoms. It also illustrates that a fungating ulcerated lesion can be the initial presentation of lung cancer in addition to nodular, papular, and zosteriform presentations noted in the literature.
METHODS: We present a case of a 55 year old Caucasian male with a 60-pack-year smoking history initially presenting with a nodule on his right upper back that quickly fungated and ulcerated requiring surgical excision. Biopsy of both the skin lesion and the lung mass confirmed squamous cell carcinoma (SCC) and the lung mass being the primary tumor. The patient\'s clinical and functional status severely declined during his hospital stay and was later discharged to hospice without therapeutic intervention. He later expired a month after hospice stay.
CONCLUSIONS: Although uncommon, this case clearly illustrates that skin metastases can be the initial finding of primary lung cancer and that not all patients with lung cancer will present with bronchopulmonary symptoms. It also illustrates that a fungating ulcerated lesion can be the initial presentation of lung cancer in addition to nodular, papular, and zosteriform presentations noted in the literature.
摘要：
背景：我们的患者出现了一种新的表现，即作为肺癌的初始表现，其表现为溃疡性皮肤损伤。文献将肺癌的皮肤转移描述为结节状，丘疹,和zosteriform。我们的病例是一种胃溃疡性皮肤病变，文献中未广泛报道。仍然需要更多有关此类病例的临床表现和预后的数据，因为它将阐明诊断挑战和治疗管理。
方法：我们介绍了一例55岁的白人男性，有60年的吸烟史，最初表现为右上背部有一个结节，快速形成溃疡，需要手术切除。皮肤病变和肺肿块的活检证实鳞状细胞癌（SCC），肺肿块是原发性肿瘤。患者的临床和功能状态在住院期间严重下降，后来在没有治疗干预的情况下出院到临终关怀医院。他后来在临终关怀住院一个月后去世。
结论：虽然不常见，该病例清楚地表明，皮肤转移可能是原发性肺癌的最初发现，并非所有肺癌患者都会出现支气管肺症状。它还说明，除了结节状之外，底孔性溃疡病变可能是肺癌的初始表现，丘疹,以及文献中提到的zosteriform演示文稿。
方法：我们介绍了一例55岁的白人男性，有60年的吸烟史，最初表现为右上背部有一个结节，快速形成溃疡，需要手术切除。皮肤病变和肺肿块的活检证实鳞状细胞癌（SCC），肺肿块是原发性肿瘤。患者的临床和功能状态在住院期间严重下降，后来在没有治疗干预的情况下出院到临终关怀医院。他后来在临终关怀住院一个月后去世。
结论：虽然不常见，该病例清楚地表明，皮肤转移可能是原发性肺癌的最初发现，并非所有肺癌患者都会出现支气管肺症状。它还说明，除了结节状之外，底孔性溃疡病变可能是肺癌的初始表现，丘疹,以及文献中提到的zosteriform演示文稿。
