Single Subcutaneous Nodule as Initial Presentation of Atypical Lung Carcinoid

We report a 50-year-old woman whose atypical lung carcinoid presented as a single subcutaneous nodule. Biopsy of the nodule revealed neuroendocrine carcinoma likely from the lungs. Imaging studies revealed masses in lungs, pelvis and right axilla, and a seizure a few months later lead to discovery of brain metastasis. This case illustrates that an apparently innocuous subcutaneous nodule could be the initial presentation of an otherwise asymptomatic but widely metastatic atypical lung carcinoid. Physicians should be aware of signs of skin metastasis from lung malignancies and judiciously select patients with subcutaneous nodule for biopsy.