Cutaneous lesion mimicking a lung mass

Case contributed by Jan Frank Gerstenmaier
Diagnosis certain

Presentation

This patient with a history of smoking was referred by his GP because of chronic cough.

Patient Data

Age: 70 years
Gender: Male

Chest radiograph

x-ray

A 3 cm round density is projected in the right upper zone. No other focal pulmonary abnormality is apparent. Heart and mediastinal contours appear normal.

The patient was referred to the rapid access lung cancer clinic for urgent investigation of a suspected lung tumor.

Selected images from a CT...

ct

Selected images from a CT chest

CT performed three days later demonstrates a 3 cm cutaneous lesion at the right upper back, accounting for appearances on chest radiograph. There was no evidence of a pulmonary tumor.

Case Discussion

This lesion can easily be identified by clinical examination. Features on a radiograph suggestive of an extrapulmonary location include sharp circumscription, and the incomplete border sign.

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