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Cutaneous Metastasis of Osteosarcoma on the Scalp---a case report and literature review
Chiu-Yen Ho , Kuo-Chia Yang , Wu-hui Chang , Julia H. Chang , Yu-Tung Yao
Dermatol Sinica 24:123-130,2006

Osteosarcoma is the most common primary malignant neoplasm of the bone. The
mode of metastasis is mainly hematogenous. The most frequent metastatic sites of
osteosarcoma are the lung, bones and kidneys. After a review of the literature,
cutaneous metastasis of osteosarcoma is an extremely rare event with only few
reported cases. Hereby we present a 38-year-old man with a primary osteoblastic
osteosarcoma in the left mandible. He received radical surgery and regular follow up.
At 2 years, lung metastasis was suspected due to persistent cough, chest pain radiating
to the back and mediastinal lung mass. Owing to refusing chemotherapy, radiation
therapy was suggested. However, he developed a 0.8x1 cm sized, painful, indurated
erythematous carbuncle like nodule on his scalp for 7 weeks after lung metastasis
occurred. Histological examination of the lesion revealed metastatic osteosarcoma. To
our knowledge, osteosarcoma metastasis to the skin is an extremely rare event and
this case suggests that cutaneous metastasis should be highly suspected in a case of
osteosarcoma with carbuncle –like skin nodule even though cutaneous metastasis is
rare. Cutaneous metastasis in a patient of osteosarcoma should not be treated as a
simple event.

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