Melanoma is one of the most metastasizing cancers, and its morbidity and mortality are mostly determined by metastatic disease. Cutaneous metastases are a frequently encountered event in the natural history of the disease, in the early as well as in the late stages, with a significantly higher survivial rate than visceral metastases. The mechanisms that drive the metastatic process are very complex, incompletely clarified, and involve a series of intrinsic and extrinsic tumoral factors. The host's setting plays a fundamental role for enabling or inhibiting tumor growth and metastasis in accordance to the tumor's developmental phase.Skin metastases frequently raise differential diagnosis issues, from a clinical, dermatoscopic and histopatological point of view, involving both benign and malignant entities.
Presently, numerous therapeutic options are available, local and systemic, on whose choice one must take into account the disease extension, the presence of systemic disease and the patient's comorbidities. Available treatments have a curative role if cutaneous metastases represent the sole manifestation of the disease, surgical treatment remaining the gold standard, or a palliative role for extensive, inoperable lesions or accompaning systemic dissemination.
This paper is a review of present-day scientific data of melanoma skin metastasis, regarding the mechanisms of metastasis, the clinical and pathological aspects, and of clinical and differential diagnosis issues, as well as of the therapeutic options available today.