An 86-year-old woman presented with nodular thickening of her scalp over an oval area of approximately 12.0 cm in greatest dimension. The nodular area had a purplish discoloration and appeared like a bruise, and there was no crusting. The patient had otherwise no significant past medical history. A wide local excision was performed. Pathologic examination revealed a 10.0 cm, gray-white to purple, rubbery, nodular scalp mass with strands of hair extending from the surface.
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• Kaposi sarcoma
• Malignant melanoma
• Spindle cell hemangioma
• Spindle cell squamous cell carcinoma
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