As a primary malignant bone tumor, osteosarcoma is second only to chondrosarcoma. Although it commonly metastasizes and is aggressive in nature, it rarely colonizes the skin. This is a report of a 22-year-old male with osteosarcoma of the pelvis and metastasis to the lungs and chest wall who developed a clinically unsuspected solitary cutaneous metastasis in the scalp. Instead of the expected cyst, incisional biopsy disclosed a solid tan nodule of chondro-osseous sarcoma. Although rare, cutaneous metastases from osteosarcoma may appear in skin, especially the scalp, or in skin over the primary tumor. New skin lesions in a patient with a history of osteosarcoma warrant investigations including imaging and biopsy.
From the *New York Medical College, Valhalla, NY; †Central Coast Pathology; ‡Western Dermatopathology, San Luis Obispo, CA; §Department of Clinical and Molecular Pharmacology, City of Hope, Duarte, CA; and ‖Dermatology Medical Group, Oxnard, CA.
Presented as a poster at the Musculoskeletal Radiology Sarcoma Conference in June of 2008 by author M.I.R.
Reprints: Larisa M. Lehmer, MA, Central Coast Pathology, 3701 S. Higuera Street, Suite 200, San Luis Obispo, CA 93401 (e-mail: firstname.lastname@example.org).