When dermoscopy of a nodule on the hysterectomy scar reveals peritoneal carcinomatosis from high-grade serous tubal carcinoma.

Cutaneous metastases are rare but clinically relevant manifestations of internal malignancies, occurring in fewer than 10% of cases and in only a small fraction of gynecologic cancers. They most commonly arise from ovarian carcinoma, while tubal carcinoma rarely produces such lesions. Their occurrence on a surgical scar is particularly unusual and may result from intraoperative tumor seeding or the permissive microenvironment of scar tissue, characterized by neoangiogenesis, impaired barrier function, and reduced local immunity. We present the case of a woman with high-grade serous tubal carcinoma whose recurrence began as a painful nodule and papules on the hysterectomy scar, later extending into infiltrated nodules across the lower abdomen and thigh roots. Dermoscopy revealed a diffuse erythematous background with polymorphic vascular structures, including serpentine vessels. Biopsy confirmed cutaneous metastasis. This case emphasizes dermoscopy's diagnostic role in rare scar-associated cutaneous metastases.