Snapshot quiz 19/5
Authors: Parkin E, Johnston R and Selvasekar C
This is a subcutaneous metastasis from colorectal carcinoma at a previous cholecystostomy drain site. The patient underwent cholecystostomy in 2014 followed by cholecystectomy in 2015. He had an open right hemicolectomy in 2016 for a T3 N0 caecal adenocarcinoma and presented with this subcutaneous lesion 2 years later. It was treated by wide local excision and primary closure. Subcutaneous metastases occur in less than 1 per cent of patients with colorectal carcinoma, usually in the setting of advanced disease. Any non-healing skin ulcer where there is a history of colorectal carcinoma should be considered as potentially malignant.