Case Report: Cutaneous Metastases from Colorectal Cancer: A Rare Case of Isolated Skin Recurrence

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Background Cutaneous metastases from colorectal cancer (CRC) are rare, occurring in fewer than 5% of metastatic cases, and typically indicate advanced disease with poor prognosis. Case presentation We report the case of a 42-year-old man previously treated with curative surgery and adjuvant chemotherapy for rectosigmoid adenocarcinoma. Eighteen months after completion of therapy, he presented with pruritic eczematous skin lesions in the right inguinal fold, gluteal region, and perianal area. Biopsy revealed metastatic adenocarcinoma of colorectal origin (CK20-positive/CK7-negative). Restaging CT scan demonstrated new non-necrotic lymphadenopathy at the aortic bifurcation and bilateral internal iliac chains, without visceral metastases. The disease was classified as unresectable metastatic recurrence (stage IV). The patient was referred for palliative systemic therapy, with molecular profiling (RAS/BRAF/MSI) to guide treatment. Conclusions Cutaneous metastases are an uncommon manifestation of CRC recurrence and may mimic benign dermatologic conditions. Prompt biopsy of atypical skin lesions in CRC survivors is crucial for early detection. Systemic therapy remains the cornerstone of management, guided by molecular features. Emerging immunotherapy and anti-angiogenic combinations offer potential benefit even in microsatellite-stable disease.

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