Carcinoma en Cuirasse Revealing Urothelial Carcinoma Recurrence
Cutaneous metastases comprise a broad spectrum of clinical presentations. Carcinoma en cuirasse (CeC) refers to a metastatic encasement of the chest by firm papulonodules or sclerodermoid plaques with a dismal prognosis. As frequently perceived to solely constitute a rare subtype of breast cancer metastasis, CeC has been documented only occasionally in variant sites of primary origin, such as the lungs, kidneys, or stomach. Here, we report the first case of CeC derived from urothelial carcinoma.
An 81-year-old female presented to our dermatology outpatient department with rapidly enlarging, painless skin lesions on her anterior and posterior trunk, buttocks, and thighs. Three years prior, she had undergone radical cystectomy with lymphadenectomy and six cycles of adjuvant chemotherapy with gemcitabine plus cisplatin for locally advanced urothelial carcinoma (pT2 pN2 pL1 pV1). Tumor cells were characterized by strong GATA3 expression. Regular follow-up with her oncologist did not indicate any tumor recurrence.
Physical examination revealed hyperpigmented, well-demarcated, sclerodermoid, confluent plaques involving almost the entire thoracic and abdominal circumference, consistent with CeC (Figure 1a). We also observed secondary ulceration and peau d'orange appearance due to lymphatic obstruction. Neither breast ultrasound nor computed tomography imaging of the chest, abdomen, and pelvis provided any evidence of malignant solid tumors.
