Epithelioid malignant mesothelioma metastatic to the skin: A case report and review of the literature

J Cutan Pathol. 2017 Dec;44(12):1057-1063. doi: 10.1111/cup.13026. Epub 2017 Sep 11.

Abstract

Malignant mesothelioma (MM) is an aggressive and invasive neoplasm primarily affecting the pleura, peritoneum and pericardium. While mesothelioma commonly metastasizes to visceral organs, it has rarely been documented to involve the skin and subcutaneous tissue. There is a paucity of reports of cutaneous metastatic mesothelioma, and histologic examination is often challenging because the tumor closely mimics other primary and metastatic neoplasms. We report a case of a 75-year-old man presenting with a firm, hard nodule on his upper back, which on initial histologic evaluation resembled metastatic adenocarcinoma. However, upon review of his medical history and immunohistochemical evaluation of the lesion, the diagnosis of epithelioid MM metastatic to the skin was rendered. The purpose of this case report and review of the literature is to summarize the most effective available immunostains to aid in the diagnosis of this challenging entity, highlight the histologic similarities between metastatic epithelioid MM and other primary and metastatic neoplasms of the skin, and provide prognostic information for these rare tumors.

Keywords: cutaneous; histopathology; immunohistochemistry; mesothelioma; metastasis.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary*
  • Adult
  • Aged
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunohistochemistry
  • Lung Neoplasms / immunology
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary*
  • Male
  • Mesothelioma / immunology
  • Mesothelioma / pathology*
  • Mesothelioma / secondary
  • Middle Aged
  • Skin / pathology*
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology
  • Skin Neoplasms / secondary*
  • Subcutaneous Tissue / pathology

Supplementary concepts

  • Mesothelioma, Malignant