Background We report diagnosis and management of stage IV papillary serous uterine cancer with initial clinical presentation as a skin rash. Case A 62-year-old postmenopausal female developed an erythematous rash beginning on her right lower abdomen and progressively spreading to her left abdomen, vulva, and neck. After a trial of antibiotic treatment, biopsy of left neck and right thigh skin nodules revealed papillary serous carcinoma. Abdominopelvic tomography revealed endometrial thickening and a 5 cm left adnexal mass. Subsequent endometrial biopsy also revealed papillary serous carcinoma, with pathology similar to that of the skin lesions. She received 6 cycles of carboplatin and paclitaxel chemotherapy with improvement of her skin lesions and overall performance status. However, her CA-125 level continued to rise and she was treated with single-agent carboplatin with progression of both her internal and cutaneous disease. She was transitioned to hospice with palliative radiation and died 2 months after discontinuing chemotherapy, 10 months after presentation. Conclusion Cutaneous metastasis is a rare presentation of metastatic uterine cancer. Treatment with chemotherapy may result in a positive response and should be considered. Highlights ? The skin is a rare site of metastasis of uterine cancer. ? Metastatic uterine cancer can clinically present as skin lesions. ? Serous uterine cancer often responds to chemotherapy but is aggressive.
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