A 57-year-old man was admitted to our department with a single ulcerated skin lesion on the right lumbar zone. The patient quit smoking 1 years ago, following a history of 35 years of smoking 13 cigarettes per day. There was no evidence of respiratory symptoms, or anorexia.

The patient reported the lesion had appeared 6 months before admittance, at first as a nodule lesion. The rapid growth and the ulceration of the skin following regular dressing brought the patient to seek medical advice.

Physical examination showed a nodule, measuring approximately 1 cm in diameter, surrounded by erythematous brownish skin, prone to bleeding from a central ulcerated area (Figure 1). Complete physical examination revealed no other skin lesions. Given the rapid progression of the lesion over the previous months, we performed a diagnostic skin biopsy.

The histological examination showed several tumor cells with variable glandular formation in the deep dermis compatible with an adenocarcinoma, with features of tumor favoring primary lung cancer given the positive immunohistochemistry for cytokeratin 7 (CK7) whereas cytokeratin 20 (CK20).