PMC7290257_01
(A) Cutaneous metastatic scalp lump at presentation. (B) Skin biopsy showing pancreatic adenocarcinoma (dermal involvement of irregularly shaped aggregates of epithelium arranged as glandular structures lined by cells characterized by enlarged vesicular and hyperchromatic nuclei with conspicuous nucleoli).
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A 76-year-old gentleman with a past medical history of hypertension, alcohol abuse, and ex-smoker presented initially to the dermatology clinic with a progressively enlarging lump over his frontal scalp for 4 to 6 weeks (Figure 1).
Extensive metastatic lesions of unusual sites in computed tomography (CT) scans:skull, brain (A), liver (B, D), and lung (C). Positron emission tomography CT showing extensive metastatic spread throughout the whole body (E).
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Figure 2. Further workup with esophagogastroduodenoscopy and colonoscopy did not reveal any abnormal findings.