title: Lung carcinoma presenting as a solitary, painless frontal bone lump.
abstract: A 50-year-old patient, a smoker, was admitted to the hospital, with a solitary scalp lump. Subcutaneous lumps of the scalp are common but usually benign; however, the painless lump in our patient turned out to be a malignant osteolytic lesion of the skull. Frontal bone was involved, and the disease had spread to the dura. Neuroimaging showed osteolytic lesions involving the axial skeleton, skull and several vertebrae. MRI showed the involvement of the second cervical vertebra, which prompted us to start treatment with dexamethasone. Since the spinal cord was not involved, Oncologists decided not to start radiotherapy treatment until we had reached the final diagnosis. A frontal bone biopsy confirmed the diagnosis of lung carcinoma. Chest X-ray did not identify the pulmonary nodule, but CT scan revealed a 1 cm peripheral, spiculated, pulmonary nodule within a pathological parenchyma (severe diffuse pulmonary emphysema).
authors.affiliation: Department of Internal Medicine, Mostoles University Hospital, Mostoles, Madrid, Spain.
authors.forename: Rafael
authors.identifier: http://orcid.org/0000-0001-7532-4585
authors.initials: R
authors.lastname: García Carretero
authors.affiliation: Department of Internal Medicine, Mostoles University Hospital, Mostoles, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Sanchez-Redondo
authors.affiliation: Department of Oncology, Mostoles University Hospital, Mostoles, Madrid, Spain.
authors.forename: Maria-Jesus
authors.initials: MJ
authors.lastname: Barrio-Alonso
authors.affiliation: Department of Oncology, Mostoles University Hospital, Mostoles, Madrid, Spain.
authors.forename: Maria-Pilar
authors.initials: MP
authors.lastname: Lopez-Marti
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005624:Frontal Bone / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D008875:Middle Aged; D012535:Scalp / Q000473:pathology; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000473:pathology