Track

Case Reports

Abstract

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents and usually metastasize to the lungs, bones and kidneys. However, involvement of the skin is very rare. Like other mesenchymal tumors, osteosarcomas prefer hematogenous spread to visceral organs and lymph node metastasis are very uncommon. We present a case of a 29-year-old male patient with known history of osteoblastic osteosarcoma of the left femur with metastasis in the lungs that presented with a left frontal scalp lesion. The histologic sections showed a malignant high-grade spindle cell neoplasm in dermis. Additionally, areas of necrosis were noted. The immunohistochemical staining of the tumor was positive for SATB2 and negative for MDM2. Given the clinical setting, the histologic description and the immunohistochemical profile of the scalp lesion, the diagnosis of high-grade sarcoma consistent with metastatic osteoblastic osteosarcoma was established. Although metastatic osteosarcoma to the skin is an unusual presentation, is very important to consider this diagnosis in patients with prior history of osteosarcoma that develops new skin or subcutaneous lesions.