CTICasesActinic Keratosis
Imaging findings
Chest radiograph and CT in a patient with a history of Merkel cell carcinoma show numerous calcified and non-calcified cutaneous nodules projecting over the chest wall, scapula, and trunk. Clinical photographs show extensive, scaly skin plaques. Biopsy of the cutaneous nodules confirms actinic keratoses.
Key takeaways
Multiple cutaneous nodules on chest radiographs and CT can mimic cutaneous metastases in a patient with a known malignancy like Merkel cell carcinoma. Actinic keratoses are common, pre-neoplastic epidermal lesions related to chronic sun exposure. Recognizing the cutaneous location and scaly appearance on clinical exam is key to avoiding unnecessary biopsy or misstaging.
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