Cutaneous metastasis of esophageal adenocarcinoma with an unusual presentation

We describe an unusual presentation of a cutaneous metastasis of esophageal adenocarcinoma in the left tempero-parietal skull and the sonographic features that helped establish the diagnosis. The patient had a primary tumor surgically resected 4 years earlier and was in clinical remission at the time of presentation. The patient presented to our radiology department with a lump on the head after a fall, and sonographic examination was recommended to assess the presumed posttraumatic hematoma. The examination revealed typical features of malignancy: a superficial solid mass invading the skull surrounded by an irregular network of blood vessels. This was confirmed on CT, and a definitive diagnosis was obtained on histologic analysis following sonographically guided biopsy.