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of all cutaneous tumors&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> Its incidence has grown for a number of reasons&#44; including longer patient survival&#44; better treatment options&#44; and a higher average life expectancy among the general population&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Diagnosis is based on the integration of clinical findings and pathologic features identified in the affected skin&#46; In most cases&#44; the metastatic cells have similar histologic features to those seen in the primary tumor&#46; Because these cells may be anaplastic and poorly differentiated&#44; it is sometimes only possible to classify the lesions in general terms&#44; such as a poorly differentiated tumor with features consistent with carcinoma&#44; melanoma&#44; sarcoma&#44; or a hematolymphoid neoplasm&#46; Immunohistochemical studies are useful in such cases&#44; but pathognomonic markers are not always available&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The main aim of this study was to analyze the characteristics of cutaneous metastases in patients from 2 high-level hospitals in Santiago de Chile&#44; Chile&#46; The specific aims were to characterize demographic&#44; clinical&#44; and histopathologic features&#44; analyze the association between clinical and histopathologic features&#44; and describe overall survival rates&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material and Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a descriptive&#44; analytical&#44; retrospective&#44; observational&#44; cross-sectional study&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The study was approved by the scientific-ethics committee for both hospitals&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Cases were identified by searching through pathology reports issued between January 2005 and July 2017&#46; Cases in which skin involvement was due to local tumor extension were excluded&#46; We collected personal and clinical information from the patients&#8217; medical records and then reviewed the pathology slides and obtained dates of death from the national death registry&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Anonymity was ensured by assigning a consecutive number to each patient as they were included in the study &#40;e&#46;g&#46; 1&#44; 2&#44; 3&#41;&#46; All data thereafter were processed only by the lead investigator&#44; who was blinded to the identity of the patients at all times&#44; guaranteeing thus full anonymity&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">To be included&#44; patients had to have been diagnosed with cutaneous metastasis in the pathology departments of Hospital Cl&#237;nico de la Universidad de Chile and Hospital Barros Luco Trudeau between January 2005 and July 2017&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical Analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">Normality of distribution of continuous variables was assessed using the Shapiro-Wilk test&#46; Qualitative variables were expressed as absolute numbers and percentages&#46; Categorical variables were compared using the exact Fisher exact&#44; while continuous variables were compared using the <span class="elsevierStyleItalic">t</span> test for unpaired samples&#46; Multiple comparisons of continuous variables were performed using the Kruskal-Wallis test&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Survival was analyzed using Kaplan-Meier curves and the nonparametric log rank test was applied to analyze differences according to categorical variables&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A statistical significance of <span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;05 was established&#46; Statistical analysis was performed using Stata 12 &#40;StataCorp LP&#41;&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Sex&#46;</span> We identified 96 pathology reports for 93 patients&#58; 38 from Hospital Cl&#237;nico de la Universidad de Chile and 58 from Hospital Barros Luco Trudeau&#46; Fifty-eight patients &#40;60&#46;42&#37;&#41; were women and 38 &#40;39&#46;58&#37;&#41; were men&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Age&#46;</span> Mean &#40;SD&#41; age was 67&#46;95 &#40;13&#46;74&#41; years &#40;range&#44; 28-96 years&#41;&#46; A majority of patients were observed in the 60-to-80 group&#46; Mean age according to sex was 70&#46;05 &#40;13&#46;32&#41; years for women and 64&#46;72 &#40;13&#46;94&#41; years for men&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Comorbidities&#46;</span> The most common comorbidities were hypertension &#40;29&#46;03&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&#44; type 2 diabetes mellitus &#40;13&#46;98&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&#44; and hypothyroidism &#40;3&#46;23&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Diagnosis&#46;</span> According to the pathology reports&#44; the cutaneous metastases originated from melanoma in 26 cases &#40;27&#46;08&#37;&#41;&#44; breast adenocarcinoma in 18 &#40;18&#46;75&#37;&#41;&#44; unspecified adenocarcinoma in 15 &#40;15&#46;63&#37;&#41;&#44; digestive tract carcinoma &#40;esophagus&#44; stomach&#44; small intestine&#44; colon&#44; rectum&#44; and anus&#41; in 8 &#40;8&#46;33&#37;&#41;&#44; unspecified carcinoma in 7 &#40;7&#46;29&#37;&#41;&#44; sarcoma in 6 &#40;6&#46;25&#37;&#41;&#44; renal cell carcinoma&#44; lung carcinoma&#44; and gallbladder carcinoma in 3 cases each &#40;3&#46;13&#37;&#41;&#44; neuroendocrine carcinoma and ovarian carcinoma in 2 cases each &#40;2&#46;08&#37;&#41;&#44; and mesothelioma&#44; thyroid carcinoma&#44; and oral cavity carcinoma in 1 case each &#40;1&#46;04&#37;&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The distribution of diagnoses varied significantly according to sex &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; In the group of women &#40;58 pathology reports&#41;&#44; the cutaneous metastases originated from breast adenocarcinoma in 31&#46;03&#37; of cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41;&#44; melanoma in 27&#46;59&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#41;&#44; and unspecified adenocarcinoma in 15&#46;52&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">In the male group &#40;38 pathology reports&#41; the main primary tumors were melanoma &#40;26&#46;32&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41;&#44; unspecified adenocarcinoma &#40;15&#46;79&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41;&#44; and unspecified carcinoma &#40;15&#46;79&#37;&#44; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Clinical Manifestations</span><p id="par0095" class="elsevierStylePara elsevierViewall">The cutaneous metastases were mostly located on the abdomen &#40;29&#46;51&#37; of cases&#41; followed by the extremities &#40;29&#46;03&#37;&#41;&#44; the thorax &#40;27&#46;87&#37;&#41;&#44; the head and neck &#40;22&#46;95&#37;&#41;&#44; and the back &#40;9&#46;84&#37;&#41;&#46; For metastases from melanoma&#44; the most common locations were the extremities &#40;58&#46;82&#37;&#41;&#44; the head and neck &#40;17&#46;65&#37;&#41;&#44; and the back &#40;11&#46;76&#37;&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Patient-reported manifestations were highly variable&#46; The main manifestations reported were nodules&#44; plaques&#44; tumors &#40;solid lesions &#62;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>cm&#41;&#44; and macules&#46; They appeared as solitary or multiple lesions &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>2&#41;&#44; some with an ulcerated surface and&#47;or pigmentation&#46; They were largely painful&#44; but some were asymptomatic&#46; Photographs of 2 of the lesions are shown in <a class="elsevierStyleCrossRefs" href="#fig0020">Figures 4 and 5</a>&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The skin lesions were described for 54 cases&#46; In the remaining cases&#44; a description was missing from the file or this was not available&#46; The results are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Survival</span><p id="par0110" class="elsevierStylePara elsevierViewall">Overall survival and potential predictors were analyzed using Kaplan-Meier curves&#46; The overall survival curve for the group is shown in <a class="elsevierStyleCrossRef" href="#fig0030">Figure 6</a>&#46; Median survival&#44; calculated using the log-rank test&#44; was 10 months&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The survival curves according to primary tumor site are shown in <a class="elsevierStyleCrossRef" href="#fig0035">Figure 7</a>&#46; Median survival was 23 months for melanoma&#44; 7 months for breast adenocarcinoma&#44; and 9 months for unspecified adenocarcinoma&#46; Survival was significantly longer in patients with metastasis from melanoma than from either breast or unspecified adenocarcinoma &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;024&#41;&#46;</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Median survival according to time of presentation was 5 months for metastases detected before the primary tumor and 10 months for those detected after detection&#46; The difference was not statistically significant &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;134&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Mean survival according to time of presentation in the case of melanoma was 5 months for metastases detected before the primary tumor and 34 months for those detected later &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;074&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Histopathology</span><p id="par0130" class="elsevierStylePara elsevierViewall">Diffuse infiltration of tumor cells was observed in 69&#46;23&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41; of the 91 biopsy specimens analyzed &#40;<a class="elsevierStyleCrossRef" href="#fig0040">Figure 8</a>&#41;&#46; There were 27 cases of nodular infiltration &#40;29&#46;67&#37;&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0045">Figures 9 and 10</a>&#41; and 1 case of a mixed diffuse and nodular pattern &#40;1&#46;1&#37;&#41;&#46; Most of the specimens &#40;60&#46;44&#37;&#41; showed diffuse dermal infiltration of pleomorphic cells&#46;</p><elsevierMultimedia ident="fig0040"></elsevierMultimedia><elsevierMultimedia ident="fig0045"></elsevierMultimedia><elsevierMultimedia ident="fig0050"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Vascular invasion was observed in just 21&#46;98&#37; of cases&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">All the biopsy specimens showed an inflammatory infiltrate&#46; This was mild in 93&#46;52&#37; of cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>76&#41;&#44; lymphoplasmacytic in 84&#46;62&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>77&#41;&#44; and mixed &#40;with an associated acute component&#41; in 15&#46;38&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Margins were positive in 65&#46;93&#37; of cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>60&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">In this study&#44; we analyzed data on cutaneous metastases at 2 high-level hospitals to provide preliminary insights into the nature of this condition in our country&#46; The fact that the study was based on a retrospective review of pathology reports will have generated some selection bias&#44; as we only analyzed cutaneous metastases that had been biopsied&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The distribution of cases among men and women &#40;40&#37; vs&#46; 60&#37;&#41; is consistent with reports from the international community&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Cutaneous metastasis was first described in 1972 by Brownstein et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> who found that the most common primary tumors in men were lung cancer &#40;24&#37;&#41;&#44; colorectal carcinoma &#40;19&#37;&#41;&#44; melanoma &#40;13&#37;&#41;&#44; and squamous cell carcinoma &#40;12&#37;&#41;&#46; In women&#44; they were breast cancer &#40;69&#37;&#41;&#44; colorectal cancer &#40;9&#37;&#41;&#44; melanoma &#40;5&#37;&#41;&#44; and ovarian cancer &#40;4&#37;&#41;&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">The only data available on cutaneous metastasis for Latin America are from a study of 51 cases from Peru&#44; published in 2010&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> The most common primary tumors in this case were non-Hodgkin lymphoma&#44; breast cancer&#44; and renal cell carcinoma&#46; Contrasting with reports from the international literature&#44; we observed a high proportion of unspecified adenocarcinomas&#44; which accounted for the third most common tumor in women and the second most common one in men&#46; Just 3 cases of lung cancer were observed &#40;2 in women&#41;&#44; but this low prevalence might be because poorly differentiated adenocarcinomas and carcinomas were not studied by immunohistochemistry in the earlier years of the study&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The regional distribution of skin metastasis is not always predictable&#44; as it can be related to the location of the primary tumor and the mechanism of spread&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Cutaneous metastases from gastrointestinal tumors are preferentially located on the abdomen and this was also the case in our study&#46; Sister Mary Joseph nodule&#44; a metastatic periumbilical nodule resulting from a tumor in the abdomen or pelvis&#44; is an uncommon manifestation of visceral tumors &#40;1&#37;-3&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> It has been associated with peritoneal carcinomatosis and poor prognosis and has mainly been reported in patients with metastasis from ovarian&#44; gastrointestinal&#44; or prostate cancer&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">In our series&#44; metastases from melanoma were preferentially located on the extremities&#44; supporting reports by Plaza et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">Cutaneous metastasis is the first sign of internal malignancy in 0&#46;6&#37; of cases&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">10</span></a> and identifying the primary tumor can be difficult&#44; time-consuming&#44; and costly&#46; In our series&#44; 17 of the cutaneous metastases were diagnosed before the primary tumor and 5 of these were metastases from melanoma&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Cutaneous metastasis can have a wide variety of clinical presentations&#46; In a retrospective study of 164 cases of cutaneous metastasis from breast adenocarcinoma&#44; the most common presentations&#44; observed in 80&#37; of cases&#44; were cutaneous papules and nodules&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">11</span></a> In agreement with reports by El Khoury et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">12</span></a> the most common presentations in our study were multiple nodules followed by solitary nodules&#46; Based on the information from the patients&#8217; medical records&#44; 10 &#40;38&#46;46&#37;&#41; of the metastases from melanoma were pigmented&#46; Pigmentation was not reported for any of the metastases originating from nonmelanoma cancer&#44; although there have been reports of pigmentation in patients with breast cancer&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">13</span></a> Our analysis of clinical features was limited by the availability of medical records and the scant details given on the lesions observed during the physical examination&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Histopathologically&#44; most of the samples showed a dermal infiltrative pattern with little epidermotropism and no ulceration&#46; Noteworthy findings included the scant vascular invasion and the relatively mild nature of the inflammatory infiltrates&#44; which can possibly be explained by tumor evasion of the immune system&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Of the 24 slides corresponding to cutaneous metastases from melanoma&#44; 20&#46;83&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; showed signs of epidermotropism&#46; This rate is high compared with rates reported in the literature &#40;5&#37;-10&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a> The general presentations were quite similar&#46; There were 13 nodular and 11 infiltrative patterns&#44; with scant vascular invasion and superficial ulceration&#46; It should be noted that vascular invasion is not specific to metastasis&#44; as primary melanomas may also exhibit this feature&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">Of the variables contemplated in the survival analysis &#40;sex&#44; primary tumor&#44; and clinical presentation&#41;&#44; only primary tumor was associated with a significant difference in survival&#46; Median overall survival was 10 months&#44; but patients with cutaneous metastasis from melanoma lived longer than those with metastasis from breast adenocarcinoma and unspecified adenocarcinoma&#46; The main limitation of our survival analysis is that we did not have information on cause of death or analyze survival in relation to the involvement of other organs&#46; These 2 factors would have enhanced our findings&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusions</span><p id="par0210" class="elsevierStylePara elsevierViewall">Cutaneous metastases are rare manifestations of visceral tumors&#46; They are mainly seen in elderly patients and affect men and women similarly&#46; A high index of suspicion is essential as the clinical signs are relatively nonspecific and metastasis to the skin from a primary tumor is a sign of poor prognosis&#46; Early diagnosis is essential considering the advances that have been made in the treatment of late-stage cancer&#46; More specific immunohistochemical techniques are now available that can help to identify the primary tumor&#44; including poorly differentiated carcinoma and adenocarcinoma&#46; It is also important to integrate clinical and pathologic findings to guide the histopathologic study&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">The 3 most common primary tumors in our series were cutaneous melanoma&#44; breast adenocarcinoma&#44; and unspecified adenocarcinoma&#46; Contrasting with reports in the international literature and general cancer rates in Chile&#44; cutaneous metastases from lung cancer were not common in the male population analyzed&#46; The use of more sophisticated immunohistochemical techniques could help to identify poorly differentiated cases of adenocarcinoma and carcinoma&#44; including metastases from lung cancer&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">This study&#44; which involved a long observation period given the low frequency of cutaneous metastasis in Chile&#44; has provided preliminary insights into the situation in our country&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicts of Interest</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Background and objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cutaneous metastases &#40;CMs&#41; account for 2&#37; of skin tumors and their incidence varies between 0&#46;7&#37; and 9&#37; in patients with cancer&#46; The objective of this study was to describe and analyze the demographic&#44; clinical&#44; and histopathologic characteristics of CM in patients who visited 2 hospitals in the Santiago de Chile metropolitan region&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective&#44; descriptive&#44; analytical&#44; observational&#44; cross-sectional study&#46; We reviewed the pathology reports&#44; patient records&#44; pathology slides&#44; and dates of death for diagnosed cases of CM from the anatomic pathology departments of 2 hospitals in the Santiago de Chile metropolitan region between 2015 and 2017&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ninety-six patients with CM were included in the study&#59; 60&#46;42&#37; were women and 39&#46;58&#37; were men&#46; The mean &#40;SD&#41; age was 67&#46;95 &#40;13&#46;74&#41; years&#44; with a range of 28 to 96 years&#46; The most common primary tumor was melanoma in 27&#46;08&#37; of cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#41;&#44; followed by breast cancer &#40;18&#46;75&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41;&#44; and adenocarcinoma &#40;15&#46;63&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#41;&#46; The median time between diagnosis of the tumor and cutaneous metastasis was 9 months&#46; Patients with CM of melanoma had a higher survival rate than patients with metastasis of other primary tumors &#40;<span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; A histopathologic study of 91 slides showed that diffuse infiltration of the tissue with tumor cells was the most common pattern and vascular invasion was rare&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The results are similar to those found worldwide&#46; CM is a rare manifestation of internal tumors&#46; It presents mainly at an advanced age and is equally prevalent in both sexes&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Background and objective"
          ]
          1 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusions"
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        ]
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes y objetivo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Las met&#225;stasis cut&#225;neas &#40;MC&#41; constituyen el 2&#37; de los tumores cut&#225;neos&#44; y su incidencia var&#237;a entre el 0&#44;7&#37; y el 9&#37; de los pacientes con c&#225;ncer&#46; El objetivo de este estudio es describir y analizar las caracter&#237;sticas demogr&#225;ficas&#44; cl&#237;nicas e histopatol&#243;gicas de las MC en poblaci&#243;n consultante de 2 hospitales de la Regi&#243;n Metropolitana&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Material y m&#233;todo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo&#44; descriptivo&#44; anal&#237;tico&#44; observacional y transversal&#46; Se revisaron los informes histopatol&#243;gicos&#44; fichas&#44; l&#225;minas histopatol&#243;gicas y fechas de defunci&#243;n de los casos con diagn&#243;stico de MC del servicio de anatom&#237;a patol&#243;gica de 2 hospitales de la Regi&#243;n Metropolitana entre los a&#241;os 2005 y 2017&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 96 casos de MC&#46; El 60&#44;42&#37; fueron mujeres y el 39&#44;58&#37; hombres&#46; La edad promedio al momento del diagn&#243;stico fue de 67&#44;95<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;74 a&#241;os&#44; con un rango de 28 a 96 a&#241;os&#46; La fuente neopl&#225;sica primaria m&#225;s frecuente fue melanoma en el 27&#44;08&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#41;&#44; seguido de carcinoma de mama 18&#44;75&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41; y adenocarcinoma 15&#44;63&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#41;&#46; La mediana de tiempo entre el diagn&#243;stico del tumor y la met&#225;stasis cut&#225;nea fue de 9 meses&#46; Los pacientes con MC de melanoma presentaron una mayor sobrevida que aquellos con met&#225;stasis de otro origen &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; El examen histopatol&#243;gico de 91 l&#225;minas mostr&#243; con mayor frecuencia una infiltraci&#243;n difusa del tejido con c&#233;lulas tumorales y con baja frecuencia la presencia de permeaci&#243;n vascular&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Los resultados obtenidos se asemejan a la realidad internacional&#46; Las MC son poco frecuentes&#44; constituyendo una rara manifestaci&#243;n de neoplasias internas&#44; se presentan principalmente a edades avanzadas y en ambos sexos por igual&#46;</p></span>"
        "secciones" => array:4 [
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            "identificador" => "abst0030"
            "titulo" => "Antecedentes y objetivo"
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          1 => array:2 [
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            "titulo" => "Material y m&#233;todo"
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          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Conclusiones"
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    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Kaplan V&#44; Morales C&#44; Bobadilla F&#44; Fern&#225;ndez J&#44; Segovia L&#44; Vera V&#44; et al&#46; Caracterizaci&#243;n epidemiol&#243;gica e histopatol&#243;gica de met&#225;stasis cut&#225;neas en la poblaci&#243;n consultante de 2 hospitales de Santiago durante los a&#241;os 2005 a 2017&#46; Actas Dermosifiliogr&#46; 2019&#59;110&#58;220&#8211;226&#46;</p>"
      ]
      1 => array:1 [
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">This study forms part of the thesis by Dr Viera Kaplan within the Training Program for Dermatology and Venerology Specialists at the University of Chile&#46;</p>"
      ]
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          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Stony hard tumor with a papillary surface on the lateral aspect of the left foot&#46; Histopathologic findings consistent with a moderately differentiated tubular adenocarcinoma&#46; Integration of these findings with the information from the patient&#39;s medical record led to a diagnosis of gall bladder adenocarcinoma&#46;</p>"
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Erythematous tumor with an ulcerated surface on the skin of the right arm&#46; Biopsy findings consistent with a cutaneous metastasis from clear cell renal cell carcinoma&#46; SOX 8<span class="elsevierStyleSup">&#43;</span>&#46; SOX 8 indicates sex-determining region Y-BOX 8&#46;</p> <p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46; of Patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; of Patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Multiple nodules&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Solitary nodule&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Erythematous plaque&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pigmented macule&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Clinical Characteristics of the 54 Cases of Cutaneous Metastases Analyzed&#46;</p>"
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    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:13 [
            0 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;I&#46; Papadopoulos"
                            1 => "D&#46; Ioannides"
                            2 => "I&#46; Lefaki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Cutaneous metastases from primary internal malignancies&#58; A retrospective study from a tertiary dermatological center in Northern Greece&#44; Hippokratia"
                        "fecha" => "2014"
                        "volumen" => "18"
                        "paginaInicial" => "187"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Survival after cutaneous metastasis&#58; A study of 200 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46; Schoenlaub"
                            1 => "A&#46; Sarraux"
                            2 => "E&#46; Grosshans"
                            3 => "E&#46; Heid"
                            4 => "B&#46; Cribier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Dermatol Venereol"
                        "fecha" => "2001"
                        "volumen" => "128"
                        "paginaInicial" => "1310"
                        "paginaFinal" => "1315"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11908133"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiolog&#237;a y cl&#237;nica de las met&#225;stasis cut&#225;neas en un hospital de Lima-Per&#250;&#58; per&#237;odo 1996-2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46; Ramos"
                            1 => "H&#46; Monroy-Galvez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Dermatol Per&#250;"
                        "fecha" => "2010"
                        "volumen" => "20"
                        "paginaInicial" => "28"
                        "paginaFinal" => "38"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous metastases from internal malignancies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46; Alcaraz"
                            1 => "L&#46; Cerroni"
                            2 => "A&#46; R&#252;tten"
                            3 => "H&#46; Kutzner"
                            4 => "L&#46; Requena"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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Original Article
Epidemiologic and Histopathologic Characterization of Cutaneous Metastases in Patients Who Visited 2 Hospitals in Santiago de Chile Between 2005 and 2017
Caracterización epidemiológica e histopatológica de metástasis cutáneas en la población consultante de 2 hospitales de Santiago durante los años 2005 a 2017
V. Kaplana,
Corresponding author
vierakaplan@gmail.com

Corresponding author.
, C. Moralesb, F. Bobadillac, J. Fernándezd, L. Segoviae, V. Veraf, I. Sanhuezag
a Departamento de Dermatología y Venereología, Universidad de Chile, Santiago, Chile
b Servicio de Anatomía Patológica, Hospital Clínico de la Universidad de Chile, Santiago, Chile
c Servicio de Dermatología y Venereología, Hospital Barros Luco Trudeau, Santiago, Chile
d Servicio de Dermatología y Venereología, Hospital San José, Santiago, Chile
e Servicio de Anatomía Patológica, Hospital Barros Luco Trudeau, Santiago, Chile
f Departamento de Nutrición, Universidad de Chile, Santiago, Chile
g Facultad de Medicina, Universidad de Chile, Santiago, Chile
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Cutaneous metastasis is the result of malignant cell spread from a primary tumor to the skin&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> It is a manifestation of systemic spread and can present as the first clinical sign of disease or as a sign of recurrence or advanced disease&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">2</span></a> The tumor cells can originate from an internal tumor or a primary skin cancer&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Cutaneous metastasis has a variable incidence&#44; with rates ranging between 0&#46;7&#37; and 9&#37; depending on the series&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a> It accounts for 2&#37; of all cutaneous tumors&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> Its incidence has grown for a number of reasons&#44; including longer patient survival&#44; better treatment options&#44; and a higher average life expectancy among the general population&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Diagnosis is based on the integration of clinical findings and pathologic features identified in the affected skin&#46; In most cases&#44; the metastatic cells have similar histologic features to those seen in the primary tumor&#46; Because these cells may be anaplastic and poorly differentiated&#44; it is sometimes only possible to classify the lesions in general terms&#44; such as a poorly differentiated tumor with features consistent with carcinoma&#44; melanoma&#44; sarcoma&#44; or a hematolymphoid neoplasm&#46; Immunohistochemical studies are useful in such cases&#44; but pathognomonic markers are not always available&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The main aim of this study was to analyze the characteristics of cutaneous metastases in patients from 2 high-level hospitals in Santiago de Chile&#44; Chile&#46; The specific aims were to characterize demographic&#44; clinical&#44; and histopathologic features&#44; analyze the association between clinical and histopathologic features&#44; and describe overall survival rates&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material and Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a descriptive&#44; analytical&#44; retrospective&#44; observational&#44; cross-sectional study&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The study was approved by the scientific-ethics committee for both hospitals&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Cases were identified by searching through pathology reports issued between January 2005 and July 2017&#46; Cases in which skin involvement was due to local tumor extension were excluded&#46; We collected personal and clinical information from the patients&#8217; medical records and then reviewed the pathology slides and obtained dates of death from the national death registry&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Anonymity was ensured by assigning a consecutive number to each patient as they were included in the study &#40;e&#46;g&#46; 1&#44; 2&#44; 3&#41;&#46; All data thereafter were processed only by the lead investigator&#44; who was blinded to the identity of the patients at all times&#44; guaranteeing thus full anonymity&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">To be included&#44; patients had to have been diagnosed with cutaneous metastasis in the pathology departments of Hospital Cl&#237;nico de la Universidad de Chile and Hospital Barros Luco Trudeau between January 2005 and July 2017&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical Analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">Normality of distribution of continuous variables was assessed using the Shapiro-Wilk test&#46; Qualitative variables were expressed as absolute numbers and percentages&#46; Categorical variables were compared using the exact Fisher exact&#44; while continuous variables were compared using the <span class="elsevierStyleItalic">t</span> test for unpaired samples&#46; Multiple comparisons of continuous variables were performed using the Kruskal-Wallis test&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Survival was analyzed using Kaplan-Meier curves and the nonparametric log rank test was applied to analyze differences according to categorical variables&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A statistical significance of <span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;05 was established&#46; Statistical analysis was performed using Stata 12 &#40;StataCorp LP&#41;&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Sex&#46;</span> We identified 96 pathology reports for 93 patients&#58; 38 from Hospital Cl&#237;nico de la Universidad de Chile and 58 from Hospital Barros Luco Trudeau&#46; Fifty-eight patients &#40;60&#46;42&#37;&#41; were women and 38 &#40;39&#46;58&#37;&#41; were men&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Age&#46;</span> Mean &#40;SD&#41; age was 67&#46;95 &#40;13&#46;74&#41; years &#40;range&#44; 28-96 years&#41;&#46; A majority of patients were observed in the 60-to-80 group&#46; Mean age according to sex was 70&#46;05 &#40;13&#46;32&#41; years for women and 64&#46;72 &#40;13&#46;94&#41; years for men&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Comorbidities&#46;</span> The most common comorbidities were hypertension &#40;29&#46;03&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&#44; type 2 diabetes mellitus &#40;13&#46;98&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&#44; and hypothyroidism &#40;3&#46;23&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Diagnosis&#46;</span> According to the pathology reports&#44; the cutaneous metastases originated from melanoma in 26 cases &#40;27&#46;08&#37;&#41;&#44; breast adenocarcinoma in 18 &#40;18&#46;75&#37;&#41;&#44; unspecified adenocarcinoma in 15 &#40;15&#46;63&#37;&#41;&#44; digestive tract carcinoma &#40;esophagus&#44; stomach&#44; small intestine&#44; colon&#44; rectum&#44; and anus&#41; in 8 &#40;8&#46;33&#37;&#41;&#44; unspecified carcinoma in 7 &#40;7&#46;29&#37;&#41;&#44; sarcoma in 6 &#40;6&#46;25&#37;&#41;&#44; renal cell carcinoma&#44; lung carcinoma&#44; and gallbladder carcinoma in 3 cases each &#40;3&#46;13&#37;&#41;&#44; neuroendocrine carcinoma and ovarian carcinoma in 2 cases each &#40;2&#46;08&#37;&#41;&#44; and mesothelioma&#44; thyroid carcinoma&#44; and oral cavity carcinoma in 1 case each &#40;1&#46;04&#37;&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The distribution of diagnoses varied significantly according to sex &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; In the group of women &#40;58 pathology reports&#41;&#44; the cutaneous metastases originated from breast adenocarcinoma in 31&#46;03&#37; of cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41;&#44; melanoma in 27&#46;59&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#41;&#44; and unspecified adenocarcinoma in 15&#46;52&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">In the male group &#40;38 pathology reports&#41; the main primary tumors were melanoma &#40;26&#46;32&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41;&#44; unspecified adenocarcinoma &#40;15&#46;79&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41;&#44; and unspecified carcinoma &#40;15&#46;79&#37;&#44; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Clinical Manifestations</span><p id="par0095" class="elsevierStylePara elsevierViewall">The cutaneous metastases were mostly located on the abdomen &#40;29&#46;51&#37; of cases&#41; followed by the extremities &#40;29&#46;03&#37;&#41;&#44; the thorax &#40;27&#46;87&#37;&#41;&#44; the head and neck &#40;22&#46;95&#37;&#41;&#44; and the back &#40;9&#46;84&#37;&#41;&#46; For metastases from melanoma&#44; the most common locations were the extremities &#40;58&#46;82&#37;&#41;&#44; the head and neck &#40;17&#46;65&#37;&#41;&#44; and the back &#40;11&#46;76&#37;&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Patient-reported manifestations were highly variable&#46; The main manifestations reported were nodules&#44; plaques&#44; tumors &#40;solid lesions &#62;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>cm&#41;&#44; and macules&#46; They appeared as solitary or multiple lesions &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>2&#41;&#44; some with an ulcerated surface and&#47;or pigmentation&#46; They were largely painful&#44; but some were asymptomatic&#46; Photographs of 2 of the lesions are shown in <a class="elsevierStyleCrossRefs" href="#fig0020">Figures 4 and 5</a>&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The skin lesions were described for 54 cases&#46; In the remaining cases&#44; a description was missing from the file or this was not available&#46; The results are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Survival</span><p id="par0110" class="elsevierStylePara elsevierViewall">Overall survival and potential predictors were analyzed using Kaplan-Meier curves&#46; The overall survival curve for the group is shown in <a class="elsevierStyleCrossRef" href="#fig0030">Figure 6</a>&#46; Median survival&#44; calculated using the log-rank test&#44; was 10 months&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The survival curves according to primary tumor site are shown in <a class="elsevierStyleCrossRef" href="#fig0035">Figure 7</a>&#46; Median survival was 23 months for melanoma&#44; 7 months for breast adenocarcinoma&#44; and 9 months for unspecified adenocarcinoma&#46; Survival was significantly longer in patients with metastasis from melanoma than from either breast or unspecified adenocarcinoma &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;024&#41;&#46;</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Median survival according to time of presentation was 5 months for metastases detected before the primary tumor and 10 months for those detected after detection&#46; The difference was not statistically significant &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;134&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Mean survival according to time of presentation in the case of melanoma was 5 months for metastases detected before the primary tumor and 34 months for those detected later &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;074&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Histopathology</span><p id="par0130" class="elsevierStylePara elsevierViewall">Diffuse infiltration of tumor cells was observed in 69&#46;23&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41; of the 91 biopsy specimens analyzed &#40;<a class="elsevierStyleCrossRef" href="#fig0040">Figure 8</a>&#41;&#46; There were 27 cases of nodular infiltration &#40;29&#46;67&#37;&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0045">Figures 9 and 10</a>&#41; and 1 case of a mixed diffuse and nodular pattern &#40;1&#46;1&#37;&#41;&#46; Most of the specimens &#40;60&#46;44&#37;&#41; showed diffuse dermal infiltration of pleomorphic cells&#46;</p><elsevierMultimedia ident="fig0040"></elsevierMultimedia><elsevierMultimedia ident="fig0045"></elsevierMultimedia><elsevierMultimedia ident="fig0050"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Vascular invasion was observed in just 21&#46;98&#37; of cases&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">All the biopsy specimens showed an inflammatory infiltrate&#46; This was mild in 93&#46;52&#37; of cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>76&#41;&#44; lymphoplasmacytic in 84&#46;62&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>77&#41;&#44; and mixed &#40;with an associated acute component&#41; in 15&#46;38&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Margins were positive in 65&#46;93&#37; of cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>60&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">In this study&#44; we analyzed data on cutaneous metastases at 2 high-level hospitals to provide preliminary insights into the nature of this condition in our country&#46; The fact that the study was based on a retrospective review of pathology reports will have generated some selection bias&#44; as we only analyzed cutaneous metastases that had been biopsied&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The distribution of cases among men and women &#40;40&#37; vs&#46; 60&#37;&#41; is consistent with reports from the international community&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Cutaneous metastasis was first described in 1972 by Brownstein et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> who found that the most common primary tumors in men were lung cancer &#40;24&#37;&#41;&#44; colorectal carcinoma &#40;19&#37;&#41;&#44; melanoma &#40;13&#37;&#41;&#44; and squamous cell carcinoma &#40;12&#37;&#41;&#46; In women&#44; they were breast cancer &#40;69&#37;&#41;&#44; colorectal cancer &#40;9&#37;&#41;&#44; melanoma &#40;5&#37;&#41;&#44; and ovarian cancer &#40;4&#37;&#41;&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">The only data available on cutaneous metastasis for Latin America are from a study of 51 cases from Peru&#44; published in 2010&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> The most common primary tumors in this case were non-Hodgkin lymphoma&#44; breast cancer&#44; and renal cell carcinoma&#46; Contrasting with reports from the international literature&#44; we observed a high proportion of unspecified adenocarcinomas&#44; which accounted for the third most common tumor in women and the second most common one in men&#46; Just 3 cases of lung cancer were observed &#40;2 in women&#41;&#44; but this low prevalence might be because poorly differentiated adenocarcinomas and carcinomas were not studied by immunohistochemistry in the earlier years of the study&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The regional distribution of skin metastasis is not always predictable&#44; as it can be related to the location of the primary tumor and the mechanism of spread&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Cutaneous metastases from gastrointestinal tumors are preferentially located on the abdomen and this was also the case in our study&#46; Sister Mary Joseph nodule&#44; a metastatic periumbilical nodule resulting from a tumor in the abdomen or pelvis&#44; is an uncommon manifestation of visceral tumors &#40;1&#37;-3&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> It has been associated with peritoneal carcinomatosis and poor prognosis and has mainly been reported in patients with metastasis from ovarian&#44; gastrointestinal&#44; or prostate cancer&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">In our series&#44; metastases from melanoma were preferentially located on the extremities&#44; supporting reports by Plaza et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">Cutaneous metastasis is the first sign of internal malignancy in 0&#46;6&#37; of cases&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">10</span></a> and identifying the primary tumor can be difficult&#44; time-consuming&#44; and costly&#46; In our series&#44; 17 of the cutaneous metastases were diagnosed before the primary tumor and 5 of these were metastases from melanoma&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Cutaneous metastasis can have a wide variety of clinical presentations&#46; In a retrospective study of 164 cases of cutaneous metastasis from breast adenocarcinoma&#44; the most common presentations&#44; observed in 80&#37; of cases&#44; were cutaneous papules and nodules&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">11</span></a> In agreement with reports by El Khoury et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">12</span></a> the most common presentations in our study were multiple nodules followed by solitary nodules&#46; Based on the information from the patients&#8217; medical records&#44; 10 &#40;38&#46;46&#37;&#41; of the metastases from melanoma were pigmented&#46; Pigmentation was not reported for any of the metastases originating from nonmelanoma cancer&#44; although there have been reports of pigmentation in patients with breast cancer&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">13</span></a> Our analysis of clinical features was limited by the availability of medical records and the scant details given on the lesions observed during the physical examination&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Histopathologically&#44; most of the samples showed a dermal infiltrative pattern with little epidermotropism and no ulceration&#46; Noteworthy findings included the scant vascular invasion and the relatively mild nature of the inflammatory infiltrates&#44; which can possibly be explained by tumor evasion of the immune system&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Of the 24 slides corresponding to cutaneous metastases from melanoma&#44; 20&#46;83&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; showed signs of epidermotropism&#46; This rate is high compared with rates reported in the literature &#40;5&#37;-10&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a> The general presentations were quite similar&#46; There were 13 nodular and 11 infiltrative patterns&#44; with scant vascular invasion and superficial ulceration&#46; It should be noted that vascular invasion is not specific to metastasis&#44; as primary melanomas may also exhibit this feature&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">Of the variables contemplated in the survival analysis &#40;sex&#44; primary tumor&#44; and clinical presentation&#41;&#44; only primary tumor was associated with a significant difference in survival&#46; Median overall survival was 10 months&#44; but patients with cutaneous metastasis from melanoma lived longer than those with metastasis from breast adenocarcinoma and unspecified adenocarcinoma&#46; The main limitation of our survival analysis is that we did not have information on cause of death or analyze survival in relation to the involvement of other organs&#46; These 2 factors would have enhanced our findings&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusions</span><p id="par0210" class="elsevierStylePara elsevierViewall">Cutaneous metastases are rare manifestations of visceral tumors&#46; They are mainly seen in elderly patients and affect men and women similarly&#46; A high index of suspicion is essential as the clinical signs are relatively nonspecific and metastasis to the skin from a primary tumor is a sign of poor prognosis&#46; Early diagnosis is essential considering the advances that have been made in the treatment of late-stage cancer&#46; More specific immunohistochemical techniques are now available that can help to identify the primary tumor&#44; including poorly differentiated carcinoma and adenocarcinoma&#46; It is also important to integrate clinical and pathologic findings to guide the histopathologic study&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">The 3 most common primary tumors in our series were cutaneous melanoma&#44; breast adenocarcinoma&#44; and unspecified adenocarcinoma&#46; Contrasting with reports in the international literature and general cancer rates in Chile&#44; cutaneous metastases from lung cancer were not common in the male population analyzed&#46; The use of more sophisticated immunohistochemical techniques could help to identify poorly differentiated cases of adenocarcinoma and carcinoma&#44; including metastases from lung cancer&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">This study&#44; which involved a long observation period given the low frequency of cutaneous metastasis in Chile&#44; has provided preliminary insights into the situation in our country&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicts of Interest</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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            0 => "Met&#225;stasis cut&#225;nea"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Background and objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cutaneous metastases &#40;CMs&#41; account for 2&#37; of skin tumors and their incidence varies between 0&#46;7&#37; and 9&#37; in patients with cancer&#46; The objective of this study was to describe and analyze the demographic&#44; clinical&#44; and histopathologic characteristics of CM in patients who visited 2 hospitals in the Santiago de Chile metropolitan region&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective&#44; descriptive&#44; analytical&#44; observational&#44; cross-sectional study&#46; We reviewed the pathology reports&#44; patient records&#44; pathology slides&#44; and dates of death for diagnosed cases of CM from the anatomic pathology departments of 2 hospitals in the Santiago de Chile metropolitan region between 2015 and 2017&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ninety-six patients with CM were included in the study&#59; 60&#46;42&#37; were women and 39&#46;58&#37; were men&#46; The mean &#40;SD&#41; age was 67&#46;95 &#40;13&#46;74&#41; years&#44; with a range of 28 to 96 years&#46; The most common primary tumor was melanoma in 27&#46;08&#37; of cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#41;&#44; followed by breast cancer &#40;18&#46;75&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41;&#44; and adenocarcinoma &#40;15&#46;63&#37;&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#41;&#46; The median time between diagnosis of the tumor and cutaneous metastasis was 9 months&#46; Patients with CM of melanoma had a higher survival rate than patients with metastasis of other primary tumors &#40;<span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; A histopathologic study of 91 slides showed that diffuse infiltration of the tissue with tumor cells was the most common pattern and vascular invasion was rare&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The results are similar to those found worldwide&#46; CM is a rare manifestation of internal tumors&#46; It presents mainly at an advanced age and is equally prevalent in both sexes&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Background and objective"
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          1 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Material and methods"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes y objetivo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Las met&#225;stasis cut&#225;neas &#40;MC&#41; constituyen el 2&#37; de los tumores cut&#225;neos&#44; y su incidencia var&#237;a entre el 0&#44;7&#37; y el 9&#37; de los pacientes con c&#225;ncer&#46; El objetivo de este estudio es describir y analizar las caracter&#237;sticas demogr&#225;ficas&#44; cl&#237;nicas e histopatol&#243;gicas de las MC en poblaci&#243;n consultante de 2 hospitales de la Regi&#243;n Metropolitana&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Material y m&#233;todo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo&#44; descriptivo&#44; anal&#237;tico&#44; observacional y transversal&#46; Se revisaron los informes histopatol&#243;gicos&#44; fichas&#44; l&#225;minas histopatol&#243;gicas y fechas de defunci&#243;n de los casos con diagn&#243;stico de MC del servicio de anatom&#237;a patol&#243;gica de 2 hospitales de la Regi&#243;n Metropolitana entre los a&#241;os 2005 y 2017&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 96 casos de MC&#46; El 60&#44;42&#37; fueron mujeres y el 39&#44;58&#37; hombres&#46; La edad promedio al momento del diagn&#243;stico fue de 67&#44;95<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;74 a&#241;os&#44; con un rango de 28 a 96 a&#241;os&#46; La fuente neopl&#225;sica primaria m&#225;s frecuente fue melanoma en el 27&#44;08&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#41;&#44; seguido de carcinoma de mama 18&#44;75&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41; y adenocarcinoma 15&#44;63&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#41;&#46; La mediana de tiempo entre el diagn&#243;stico del tumor y la met&#225;stasis cut&#225;nea fue de 9 meses&#46; Los pacientes con MC de melanoma presentaron una mayor sobrevida que aquellos con met&#225;stasis de otro origen &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; El examen histopatol&#243;gico de 91 l&#225;minas mostr&#243; con mayor frecuencia una infiltraci&#243;n difusa del tejido con c&#233;lulas tumorales y con baja frecuencia la presencia de permeaci&#243;n vascular&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Los resultados obtenidos se asemejan a la realidad internacional&#46; Las MC son poco frecuentes&#44; constituyendo una rara manifestaci&#243;n de neoplasias internas&#44; se presentan principalmente a edades avanzadas y en ambos sexos por igual&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Kaplan V&#44; Morales C&#44; Bobadilla F&#44; Fern&#225;ndez J&#44; Segovia L&#44; Vera V&#44; et al&#46; Caracterizaci&#243;n epidemiol&#243;gica e histopatol&#243;gica de met&#225;stasis cut&#225;neas en la poblaci&#243;n consultante de 2 hospitales de Santiago durante los a&#241;os 2005 a 2017&#46; Actas Dermosifiliogr&#46; 2019&#59;110&#58;220&#8211;226&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">This study forms part of the thesis by Dr Viera Kaplan within the Training Program for Dermatology and Venerology Specialists at the University of Chile&#46;</p>"
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          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Stony hard tumor with a papillary surface on the lateral aspect of the left foot&#46; Histopathologic findings consistent with a moderately differentiated tubular adenocarcinoma&#46; Integration of these findings with the information from the patient&#39;s medical record led to a diagnosis of gall bladder adenocarcinoma&#46;</p>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pigmented macule&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;85&nbsp;\t\t\t\t\t\t\n
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Article information
ISSN: 15782190
Original language: English
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Idiomas
Actas Dermo-Sifiliográficas
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