<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1025-0255</journal-id>
<journal-title><![CDATA[Revista Archivo Médico de Camagüey]]></journal-title>
<abbrev-journal-title><![CDATA[AMC]]></abbrev-journal-title>
<issn>1025-0255</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Camagüey]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1025-02552018000400531</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Nariz de payaso como manifestación metastásica en piel de un cáncer del pulmón]]></article-title>
<article-title xml:lang="en"><![CDATA[Clown nose as a metastatic manifestation in skin of a lung cancer]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García Rodríguez]]></surname>
<given-names><![CDATA[Miguel Emilio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A1 "/>
<xref ref-type="aff" rid="Af1"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de Camagüey Hospital Universitario Manuel Ascunce Domenech ]]></institution>
<addr-line><![CDATA[Camagüey ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2018</year>
</pub-date>
<volume>22</volume>
<numero>4</numero>
<fpage>531</fpage>
<lpage>539</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1025-02552018000400531&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1025-02552018000400531&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1025-02552018000400531&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Fundamento: las metástasis cutáneas se producen entre el 0,7 y 9 % de los pacientes con cáncer. Suelen ser un signo tardío en la evolución de la mayoría de las neoplasias, aunque en ocasiones pueden ser su forma de presentación. Las neoplasias de pulmón, mama, melanoma, cavidad oral, colon, hígado, ovario y estómago son las responsables del 80-90 % de las metástasis cutáneas en adultos.  Objetivo: presentar el caso de un paciente con una metástasis de un carcinoma epidermoide del pulmón al hígado y en la piel de la nariz, lo que constituye el signo de nariz de payaso.  Caso clínico: paciente negro de 72 años de edad, fumador de más de 50 años, con antecedentes de hipertensión arterial que acude al hospital por presentar una lesión inflamada y ulcerada de la piel de la nariz la cual había sido tratada como una infección de partes blandas superficiales. En el estudio clínico, así como histopatológico se demostró un carcinoma epidermoide de pulmón con poca diferenciación, con metástasis hepática y a la piel de la nariz. El paciente falleció dos meses después del diagnóstico.  Conclusiones: la presencia de lesiones en piel y de la nariz en particular, indica en ocasiones realizar estudios más específicos para buscar enfermedades oncológicas como el caso que se presenta con el signo de nariz de payaso.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background:  cutaneous metastasis occurs between 0.7 % and 9 % of cancer patients. They tend to be a late sign in the evolution of most neoplasms, although at times they may be their presentation. Neoplasms of lung, breast, melanoma, oral cavity, colon, liver, ovary and stomach are responsible for 80-90 % of cutaneous metastasis in adults.  Objective:  to present the case of a patient with a metastasis of an epidermoid carcinoma of the lung, the liver and on the skin of the nose, constituting the clown's nose sign.  Clinical case:  a 72-year-old black patient, smoker of more than 50 years, with a history of arterial hypertension, who comes to the hospital because he presented an inflamed and ulcerated lesion of the skin of the nose which had been treated as a superficial soft tissue infection. In the clinical study, as well as histopathological, an epidermoid carcinoma of the lung with little differentiation, with liver metastasis and the skin of the nose was demonstrated. The patient died two months after diagnosis.  Conclusions:  the presence of skin lesions and, in the case of the nose particularly, sometimes indicate more specific studies to search oncological diseases such as the case of the clown nose sign.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[NEOPLASIAS PULMONARES]]></kwd>
<kwd lng="es"><![CDATA[NARIZ]]></kwd>
<kwd lng="es"><![CDATA[METÁSTASIS DE LA NEOPLASIA]]></kwd>
<kwd lng="es"><![CDATA[ANCIANO]]></kwd>
<kwd lng="es"><![CDATA[INFORMES DE CASOS]]></kwd>
<kwd lng="en"><![CDATA[LUNG NEOPLASMS]]></kwd>
<kwd lng="en"><![CDATA[NOSE]]></kwd>
<kwd lng="en"><![CDATA[NEOPLASM METASTASIS]]></kwd>
<kwd lng="en"><![CDATA[AGED]]></kwd>
<kwd lng="en"><![CDATA[CASE REPORTS]]></kwd>
</kwd-group>
</article-meta>
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