REPORT OF A CASE
A 68-year-old white woman with stage III ovarian carcinoma presented to the dermatology clinic with multiple enlarging skin lesions of 1 month's duration. The lesions began on the scalp and had spread to involve her face, trunk, and extremities. They were asymptomatic.Physical examination revealed numerous reddish-brown indurated papules and plaques on the face, scalp, trunk, and proximal extremities (Figs 1 and 2).An initial skin biopsy specimen was interpreted as a largecell lymphoma. Several months later, a second biopsy specimen showed a dense infiltrate composed of large pleomorphic cells with vesicular nuclei and scattered mitoses (Fig 3). Some of the cells had an eosinophilic cytoplasm (Fig 4). A myeloperoxidase stain was strongly positive (Fig 5). T- and B-cell markers were uniformly negative. A bone marrow biopsy was recommended, and the specimen confirmed the diagnosis.What is your diagnosis?
Granulocytic sarcoma (GS) of the skin.
BONE MARROW BIOPSY
Fridus SR, Rodman OG, Cyran SJ, Cardelli MB. Multiple Papules and Plaques in a Patient With Ovarian Carcinoma. Arch Dermatol. 1993;129(6):775-776. doi:10.1001/archderm.1993.01680270115016