CPD • Clinicopathological case CED Clinical and Experimental Dermatology CPD Cutaneous metastasis in a patient with multiple malignancies R. C. Liu, 1 R. Dutta 2 and D. F. Sebaratnam 3 1 Department of Dermatology, Westmead Hospital, Westmead, NSW, Australia; 2 Kossard Dermatopathologists, Sydney, NSW, Australia; and 3 The Skin Hospital, Sydney, NSW, Australia doi: 10.1111/ced.13662 Clinical findings An 85-year-old woman presented with a 6-week his- tory of painful eruptive papules affecting her lower abdomen. The pain was sufficiently severe to cause functional impairment with activities of daily living, and exerted a significant burden on her quality of life. Her medical history included cutaneous squamous cell carcinoma, melanoma, ovarian papillary serous adeno- carcinoma and breast cancer (diagnosed radiologically without histological subtyping). Physical examination demonstrated hard papules and plaques affecting the right lower abdomen, mons and labia majora, many of which were tethered (Fig. 1). Histopathological findings Biopsy of a representative papule was consistent with cutaneous metastasis (Fig. 2). Histopathology demon- strated an infiltrating adenocarcinoma composed of ducts and glands. Lesional cells showed pleomorphic nuclei and prominent eosinophilic nucleoli. Several mitotic figures and apoptotic bodies were identified. The cells were positive for CK7, CA125, WT1, 34BE12, Pax8 and ER, and negative for Gata-3, PR, SOX-10, S100 and CK20. What is your diagnosis? Correspondence: Dr Rose Liu, Westmead Hospital, Corner of Darcy Road and Hawkesbury Road, Westmead, NSW 2145, Australia E-mail: rosecwliu@gmail.com Conflict of interest: the authors declare that they have no conflicts of interest. Accepted for publication 27 November 2017 Figure 1 Hard papules affecting the lower abdomen, mons and labia majora. ª 2018 British Association of Dermatologists Clinical and Experimental Dermatology 1 CPD