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Clinical Images

A Cutaneous Conundrum

Rajani Sharma, MD; Jackleen Marji, MD, PhD; Diana C. Anderson, MD, M.Arch; Marc E. Grossman, MD, FACP
New York-Presbyterian Hospital, Columbia University Medical Center

October 10, 2014 

A 90-year-old man with a remote history of benign prostatic hypertrophy presented for evaluation of progressive weight loss, fatigue, and multiple 1-2 cm non-pruritic, non-tender pink, firm, dome-shaped smooth nodules on the face, scalp, neck, chest, and upper back. Initial bloodwork was notable for elevated prostate specific antigen, PSA >1000 ng/mL. Computed tomography imaging of the pelvis showed prostatic hypertrophy measuring 5.6 cm x 6.2 cm and diffuse lytic and blastic osseous metastases, confirmed by nuclear bone scan. 

A-Cutaneous-Conundrum_Image1_Anderson.jpg 

A skin biopsy specimen of a representative nodule revealed infiltrate composed of round large cells with prominent nucleoli in the dermis. Immunohistochemical staining was positive for PSA (diffuse brown staining), confirming the diagnosis.  

A-Cutaneous-Conundrum_Image2.jpg 

 



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REFERENCES

Bailey C, Broadbent A. Cutaneous Metastases of Prostate Cancer. J Palliat Med. 2007;10(4):980-82.

Van Meter JR, Owen CE, Bahrami S, Callen JP. Rare cutaneous manisfestation of prostate cancer. Arch Dermatol. 2010;146:206-208.
 

 

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