During the physical examination a doctor look for signs in the body of a patient to get information to fit his/her pattern recognition strategy. There are some areas that can be missed in a routine daily consultation like the scalp, the breast in women, the sole, the elbow, etc. Here we show an example of this situation.
DIAGNOSIS: subcutaneous metastases in the scalp from a carcinoma of unknown origin
COMMENTS: There are places like the scalp or the supraclavicular area where the prevalence of a pathological sign is very low and usually they are left appart in the physical examination. But in some occassions you are going to find there an important sign that can change the prognosis of a patient.