Pneumothorax: a classical presentation of metastatic scalp angiosarcoma.

Metastatic pulmonary angiosarcomas frequently present with pneumothorax, especially those arising from the scalp. The metastases on chest radiographs are initially subtle and easily missed. Computed tomographic scans can show a spectrum of diagnostic findings that may be misinterpreted because of a lack of awareness related to the rarity of the disease. We report a patient who presented with pneumothorax and lung cysts before his primary scalp angiosarcoma was diagnosed. This case highlights the sometimes ominous nature of innocuous-looking, thin-walled cystic pulmonary lesions.