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Cutaneous Metastasis of Osteosarcoma in the Scalp

Ragsdale, Mary I MD*; Lehmer, Larisa M MA; Ragsdale, Bruce D MD; Chow, Warren A MD§; Carson, Robert T MD

The American Journal of Dermatopathology: August 2011 - Volume 33 - Issue 6 - p e70-e73
doi: 10.1097/DAD.0b013e318214a7ea
Extraordinary Case Report

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: llehmer@ccpathology.com).

© 2011 Lippincott Williams & Wilkins, Inc.