Lung cancer cells run all over the body, and “pimples” appear under the skin need to be careful, and the transfer to the subcutaneous is also an advanced stage

Yesterday, a netizen consulted that the patient with stage 1B lung adenocarcinoma more than three years after surgery (right lower lobe resection) received prophylactic 4-stage chemotherapy after surgery, and found a soy-sized nodule on the left chest wall. Years, tenderness, activities can be, the size does not seem to change. A color Doppler ultrasound was performed, and a 1.0*0.6cm hyperechoic nodule was seen subcutaneously on the left chest wall with a clear boundary. The report did not say blood flow signal, so lipoma was considered. This netizen is very worried about whether it will be a subcutaneous metastatic nodule of lung cancer.

Can lung cancer metastasize subcutaneously? Yes, except for lung cancer, it can be said that all malignant tumors may have subcutaneous metastasis, but the incidence of this type of metastasis is relatively low. Subcutaneous metastasis of lung cancer to form nodules can occur alone, that is, there is no metastasis in other parts, only subcutaneous metastasis, or it may be accompanied by metastasis in other parts. Compared with metastases in other parts of the viscera, subcutaneous metastases can be felt by patients themselves. They are generally painless to the touch, and grow faster. Generally, the alertness is caused by the size of peanuts.

Subcutaneous metastasis of primary lung cancer is relatively rare, and it is one of the metastatic sites for distant metastasis of advanced lung cancer. The literature shows that subcutaneous metastasis of lung cancer is mainly hematogenous metastasis, and hematogenous metastasis is characterized by extensive metastasis in multiple organs and multiple sites in the body, and the metastases can be far apart. Hematogenous metastases are mainly adenocarcinoma and small cell poorly differentiated carcinoma. Subcutaneous metastatic nodules that metastasize by the lymphatic route are relatively rare. Tumor cells invade the lymphatic vessels first, and then spread against the lymphatic fluid, which can not only involve the adjacent lymph nodes, but also reach the subcutaneous nodules along the finer branches of the lymphatic vessels to form subcutaneous metastatic nodules. It can be seen in the subcutaneous abdominal wall and the subcutaneous chest wall, and patients with multiple nodules formed under the scalp are also seen clinically.

For lung cancer patients, during the follow-up review, if there is a small nodule on the skin or under the skin that has not been seen before

, be sure to contact your doctor in time. Do B-ultrasound first. B-ultrasound is relatively reliable in distinguishing subcutaneous metastases from lipomas. Metastatic nodules usually have blood flow signals, while lipomas have no blood flow signals. In addition, the texture of lipoma is slightly soft, and the texture of metastatic cancer is hard or tough, and the growth rate is also different. Lipoma changes slowly, and metastatic cancer will change within a few months, and it will increase and become larger. If you find a subcutaneous nodule, you are really worried. You can perform puncture examination and excision for pathological examination. Pathological diagnosis is the gold standard.

From clinical experience, most lung cancer patients with subcutaneous metastases are accompanied by metastases to other organs, with high degree of malignancy, rapid disease progression and poor prognosis. The treatment principle is the same as that of other advanced lung cancer patients. Patients with sensitive gene mutations are the first choice for targeted therapy. Small cell lung cancer is the first choice for chemotherapy, and it can also be combined with immunotherapy.