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Pigmented squamous cell carcinoma in situ of the eyelid

include arsenic exposure, genetic susceptibility, chronic interstitial pneumonitis, ionizing radiation, atmospheric pollution and asbestos exposure. Our patient was living in a highly polluted industrial area in South China. Cutaneous metastases from lung cancer represent a poor prognostic indicator. The average survival rate ranges from 3 to 5 months, which is significantly lower than other malignancies including melanoma and breast cancer. Due to multi-organ metastases, our patient died before implementing further treatment. In this condition early diagnosis remains a challenge.