# Case of cutaneous metastasis from presumed poorly differentiated thyroid carcinoma: a case report

## TL;DR

A 28-year-old woman in Ethiopia presented with skin metastases likely from thyroid cancer, highlighting the rarity and challenges in diagnosing such cases.

## Contribution

This case report adds to the limited literature on cutaneous metastasis from presumed poorly differentiated thyroid carcinoma in Ethiopia.

## Key findings

- The patient had multiple ulcerated nodules and a neck mass consistent with metastatic thyroid carcinoma.
- Diagnosis was limited by lack of immunohistochemistry and thyroid biopsy, leading to a presumed diagnosis.
- The patient's condition highlights the poor prognosis associated with cutaneous metastases.

## Abstract

Cutaneous metastasis from internal malignancy is relatively uncommon and may rarely be the presenting sign of an internal malignancy. The current investigation included a case of cutaneous metastasis from presumed poorly differentiated thyroid carcinoma at Addis Ababa University (Black Lion Hospital) in Addis Ababa, Ethiopia. We present this case report to help with the early diagnosis and treatment of cutaneous metastasis from presumed poorly differentiated thyroid carcinoma.

A 28-year-old Ethiopian female presented to the Dermatology Department at the Faculty of Medicine at Addis Ababa University (Black Lion Hospital) in Addis Ababa with multiple, round, ulcerated nodules on the scalp for 6 months and small round skin-colored subcutaneous nodules on the neck, abdomen, back, and chest. She also had a mobile, firm, nontender, and multinodular anterior neck mass that moved upon swallowing. The patient was diagnosed with cutaneous metastasis from presumed poorly differentiated carcinoma, considering the top differential diagnosis, thyroid carcinoma. Owing to a lack of immunohistochemistry and inability to perform a thyroid biopsy, we could not explicitly state that this was cutaneous metastasis from thyroid carcinoma. Treatment followed the regimen appropriate for the primary metastatic malignancy. Local treatment options include imiquimod cream, liquid nitrogen cryotherapy, photodynamic therapy, excision, carbon dioxide laser therapy, pulsed dye laser therapy, topical and intralesional chemotherapy, and cytokines. The patient deferred follow-up and passed away after 3 months of the initial presentation.

A multidisciplinary treatment approach, including medical, surgical, radiation, oncologists, and mental health care providers. Cutaneous metastases are typically indicative of disseminated disease and portend a correspondingly poor prognosis.