Secondary Presentation of Mantle Cell Lymphoma in the Subgaleal Layer of the Scalp

We present the case of a male aged 57, with a 1.5 cm stage 11b right laterocervical tumour and a 3 cm ipsilateral occipital tumour, of 5 year duration, which had progressively enlarged over the last few months. A cervical scan was performed which showed a right laterocervical adenopathy, 17 mm in diameter, with no signs of normal lipid hilum, and a occipital tumour suggestive of fibrolipoma. Computed tomography (CT) of the spine showed other lymph nodes with clinical criteria of adenopathy at right sublingual level and an asymmetry of right occipital musculature (Fig. 1). Fine-needle aspiration was non-specific, and it was therefore decided to carry out an excisional biopsy of the lymph node and occipital tumour. The histopathological report of the 2 specimens revealed mantle cell lymphoma (MCL) which was confirmed by immunohistological and molecular testing, showing the translocation of the Bcl-1 gene using the FISH technique (Fig. 2). The haematological service staged the patient as IV-A as the tumour had spread to the