Primary cutaneous osteosarcoma of the scalp: a case report and review of the literature

Abstract

We report on an 84-year-old man with a solitary, nodular lesion on the scalp. The patient had been previously submitted to electrodessications of the scalp due to multiple solar keratoses. Histopathologically, the lesion showed features of a high-grade conventional osteoblastic osteosarcoma involving the dermis. Computed tomography showed no involvement of the underlying bone tissues. Clinical examination and extensive total body radiologic workup revealed absence of bone lesions in any body site, thus suggesting a final diagnosis of primary cutaneous extraskeletal osteosarcoma. The clinico-pathological features of the case are discussed in light of the rare cases previously described in the literature.Massi D, Franchi A, Leoncini G, Maio V, Dini M. Primary cutaneous osteosarcoma of the scalp: a case report and review of the literature.

Ossifying Dermatofibroma With Osteoclast-Like Giant Cells: Report of a Case and Literature Review

“…10,32,33 Although not recognized as a specific World Health Organization histopathologic subtype, extraskeletal osteosarcomas under the heading of primary cutaneous osteosarcoma are described in the literature. 34 Depending on the histologic subtype, these tumors may contain osteoclast-like giant cells, spindle cells arranged in a storiform pattern, and bone, 10 all elements that are observed in ossifying dermatofibroma with osteoclast-like giant cells. Due to these overlapping histopathologic features, benign fibro-osseous tumors, especially those with a prominent spindle cell component, may be mistaken both clinically and histologically for osteosarcoma.…”

Cutaneous Extraskeletal Osteosarcoma on the Scar of a Previous Bone Graft

“…Skin as a primary site is rare and only 13 cases of primary cutaneous osteosarcoma have been reported to date (Table 1)5,7,9,10. With an exception of 2 undocumented cases, it occurred either on the cephalic area (5 cases) or in the extremities (lower leg 5 cases, and shoulder 1 case).…”

Cutaneous Hematopathology

“…Extraskeletal osteosarcomas (ESOS) comprise a small fraction of all osteosarcomas (approximately 2-4 %), and only 1-2 % of all soft tissue sarcomas collectively (Riddle et al 2009 ;Salamanca et al 2008 ). Case reports of ESOS arising as a primary neoplasm from the dermis and subcutis exist (Drut and Barletta 1975 ;Kobos et al 1995 ;Kuo 1992 ;Llamas-Velasco et al 2013 ;Massi et al 2007 ;Park et al 2011 ;Riddle et al 2009 ;Salamanca et al 2008 ). Risk factors for primary cutaneous osteosarcoma are similar to those for deep-seated ESOS and include a history of prior irradiation, chemotherapy, and trauma; several cutaneous OS, in fact, have arisen within remote scars (Drut and Barletta 1975 ;Kuo 1992 ;Park et al 2011 ;Riddle et al 2009 ).…”

“…Both primary and metastatic cutaneous OS present as fi rm, fl esh-colored to red or violaceous (Collier et al 2003 ;Larsen et al 2010 ;Llamas-Velasco et al 2013 ;Massi et al 2007 ;Park et al 2011 ). ESOS most commonly occurs within the deep soft tissues of the extremities, and unlike its skeletal counterpart, ESOS primarily affects middle-aged to elderly adults Riddle et al 2009 ).…”

“…Like deep-seated ESOS, primary cutaneous OS have also been identifi ed in the extremities of older adults (Drut and Barletta 1975 ;Kobos et al 1995 ;Kuo 1992 ;Park et al 2011 ;Riddle et al 2009 ;Salamanca et al 2008 ). Interestingly, cutaneous OS, whether metastatic or primary in origin, demonstrates a particular proclivity for the scalp (Collier et al 2003 ;Massi et al 2007 ;Park et al 2011 ;Ragsdale et al 2011 ).…”