LAUSR

66 nodules in the upper lobe of the left lung, both lobes of the right lung, and the left adrenal gland. A histopathological examination of the scalp tu‐ mor confirmed the presence of clinically suspect‐ ed cutaneous metastases (FIGURE 1C). Cutaneous metastases occur in 0.6% to 10.4% of patients with cancer.1 Previous studies indicat‐ ed lung cancer in men and breast cancer in women as the most common primary tumors.1,2 The diag‐ nosis is made more often in patients with previ‐ ously diagnosed cancer, and in less than one ‐third of patients it precedes or is made simultaneously with the final diagnosis, as in the presented case. The cutaneous metastases may present clinically as single or multiple nodules, papules, plaques, tumors, and ulcers, and may mimic primary skin tumors as well as numerous benign dermatoses.1-3 Keratoacanthoma ‐like skin metastases have been reported occasionally, while only 3 of 13 cases de‐ scribed so far concerned multiple lesions. Prima‐ ry tumors included lung cancer, breast cancer, A 76 ‐year ‐old man with accompanying chron‐ ic obstructive pulmonary disease, type 2 diabe‐ tes mellitus, hypertension, atrial flutter, gout, benign prostatic hyperplasia, and obesity pre‐ sented with multiple eruptive skin tumors of the scalp, clinically resembling keratoacantho‐ ma. The first lesion had occurred in the parietal region 7 months before the first visit to an out‐ patient clinic and had been slowly growing. At the same time, the patient observed similar multiple bilateral lesions in the parietal, frontal, and tem‐ poral regions (FIGURE 1A). The tumors were associ‐ ated with a periodic nocturnal stabbing pain. Re‐ gardless of these lesions, a chest radiography per‐ formed 3 months earlier as a routine screening test revealed a solitary pulmonary nodule within the upper lobe of the left lung (FIGURE 1B). Based on a transthoracic needle lung biopsy and positron emission tomography–computed tomography, the patient was diagnosed with lung adenocar‐ cinoma with the presence of satellite metastatic CLINICAL IMAGE