Spontaneous Subgaleal Abscess Associated with Lung Adenocarcinoma: First Description of This Unusual Association

Abstract

Background: Primary, spontaneous, or de novo subgaleal abscesses represent extremely rare lesions usually related to patients with risk factors and predisposing conditions for infections. They are associated with high morbidity, and a proper diagnosis can be misleading. To the best of our knowledge, this is the first reported case of a de novo subgaleal abscess not related to previous traumatic head injury and associated with lung adenocarcinoma.

Case description: A 59-year-old man was admitted to our unit because he presented fever and a palpable subcutaneous right parietal mass. No history of traumatic head injury was mentioned. The patient underwent needle aspiration of the subgaleal lesion for microbiological, histological, and cytological examination, with negative response. Chest radiograph and then thoracic computed tomography scan revealed the presence of 2 lesions in the left lung. Complete removal with surgical debridement of the parietal bone lesion was performed due to the suspicion of an abscessualized skull metastasis from a primary lung adenocarcinoma.

Conclusions: We strongly suggest a patient global assessment in the event of subgaleal abscess without history of traumatic head injury, to treat eventual associated findings as soon as possible.

Keywords: De novo; Galea aponeurotica; Lung adenocarcinoma; Osteomyelitis; Spontaneous; Subgaleal abscess.