October 2011

Fig.1

 

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History:  74 year old White Male with no previous history of skin cancer presents with sores on his scalp.  He began noticing the sores a few weeks ago  after hitting his head while getting out of his car.  He denies any weight loss, shortness of breath, lymph node swelling, night sweats, or abdominal pain

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Past Medical History:  Hypertension, unspecified heart arrhythmia.

Medications:  Atenolol, amlodipine, lipitor, aspirin, vitamin B12.

Allergies:  No known drug allergies.

Physical exam: Ulcerated heme crusted plaques in confluence at posterior scalp with satellite 1-2cm subcutaneous bluish nodule at R parietal scalp (Fig. 1).  No cervical, axillary, groin, or post-auricular lymphadenopathy.

Laboratory/imaging:  Whole body PET scan demonstrated FDG-avid soft tissue thickening of the right high parietal scalp without evidence of metastatic disease.

 

 

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