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Cleveland Clinic Journal of MedicineCutaneous Metastasis from Gastric Carcinoma

Timely diagnosis is crucial in alopecia neoplastica cases, as they often indicate poor prognosis and require immediate intervention.

A recent case study underscores the critical role of timely diagnosis in managing alopecia neoplastica, a rare form of cutaneous metastasis. A 75-year-old male patient, previously treated for gastric adenocarcinoma, presented with asymptomatic nodules and alopecia on his scalp. Subsequent tests revealed these nodules to be metastatic adenocarcinoma, emphasizing the need for vigilant monitoring in cancer patients.

HCN Medical Memo
This case serves as a poignant reminder of the importance of timely diagnosis and vigilant monitoring in patients with a history of cancer. Alopecia neoplastica, although rare, is a significant indicator of poor prognosis and often necessitates a comprehensive evaluation to guide further treatment.

Key Points:
  • The 75-year-old patient had a history of gastric adenocarcinoma treated with total gastrectomy and chemotherapy.
  • He presented with asymptomatic, rubbery nodules on his scalp that had grown over 3 months.
  • Biopsy and immunohistochemical studies confirmed these nodules as metastatic adenocarcinoma.
  • The patient was later found to have abdominal and lymph node metastases.

Alopecia neoplastica accounts for 4% of all cutaneous metastasis and is associated with a poor prognosis.

Additional Points:
  • Cutaneous metastases from visceral carcinomas are rare, with an incidence of 0.7% to 9%.
  • The scalp is a common site for such metastases, often presenting as nodules.
  • Alopecia neoplastica is most frequently associated with primary tumors in the gastrointestinal tract.
  • Proper pathologic examination and immunohistochemistry are essential for diagnosis.

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