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April 1995

Purpuric Nodules Along a Surgical Scar

Author Affiliations

Baylor College of Medicine and St Joseph Hospital, Houston, Tex

Arch Dermatol. 1995;131(4):487-488. doi:10.1001/archderm.1995.01690160115022

REPORT OF A CASE  A 38-year-old man presented to his dermatologist with two pink-to-purple nodules of 5 months' duration that were along a surgical scar on his right thigh. The patient's history included a left testicular mesothelioma diagnosed 12 years earlier at orchiectomy and multiple surgeries for the same tumor, including a lymph node metastasis in the right inguinal region at the site of the current lesions.On physical examination, two shiny nodules were found at the margins of a surgical scar on the patient's right thigh (Figure 1). The lesions were excised under local anesthesia and examined histologically. Representative areas are shown in Figures 2 through 4.What is your diagnosis?

Figure 1  .

Figure n2  .

Fingure 3  .

Figure 4  .

Purpuric Nodules Along a Surgical Sca  r

DIAGNOSIS: Metastatic malignant mesothelioma of the tunica vaginalis testis. 

HISTOPATHOLOGIC FINDINGS  A multilobular papillary proliferation was found in the dermis and subcutaneous tissues.

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