Print Email

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 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.  



 Click here to view the answer


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.