Cervical Cancer Metastasis to the Scalp Presenting as Alopecia Neoplastica

In 2007, a case was reported of a 45-year-old Japanese woman with cervical cancer metastasis to the scalp, presenting as alopecia neoplastica—a rare form of hair loss associated with metastatic cancer. Initially diagnosed with poorly differentiated squamous cell carcinoma of the cervix in 1996, she underwent surgery and remained asymptomatic until 2003. Recurrence of cancer led to metastasis to the para-aortic lymph nodes and lumbar spine, confirmed by CT and PET scans. Despite chemotherapy and radiation, widespread metastases developed, including in the liver and spine. In 2004, she experienced scalp tenderness and hair loss, with biopsy confirming metastatic cervical cancer cells in the scalp, presenting as alopecia neoplastica. This condition is characterized by metastatic cancer cells, miniaturized hair follicles, and a decrease in hair follicle number. The patient declined further cancer treatment but accepted pain management and died three months later. This case highlights the rarity of scalp metastasis from cervical cancer and the presentation of alopecia neoplastica as a sign of advanced malignancy.