PMC5846346_01
Clinical image of lesion. A purple nodule, located on the right cheek, with a diameter of 1.5 cm and an ulcerated center and surrounded by hematic crust having slightly raised edges and a firm consistency.
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It had a firm consistency, an ulceration in its center, and slightly raised edges surrounded by hematic crusts (Figure 1).
(a) The skin biopsy showed abundant hematic crust and ulcerated areas in the epidermis. Ectatic abundant vessels were observed at the entire thickness of the papillar and reticular dermis. (b) Cells with broad, abundant, clear cytoplasm in ductal arrangement were observed. This aspect was suggestive of skin metastases of glandular neoplasia, including prostate or thyroid (hematoxylin-eosin stain; original magnifications: 40x (a); 400x (a, b)).
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The biopsy of the skin nodule showed that the papillary and reticular dermis were infiltrated by abundant cells having broad, clear cytoplasm, a ductal arrangement, and ectatic vessels (Figures 2(a) and 2(b)).
Dermal infiltrate positive for prostate specific antigen (PSA). This marker is usually positive in prostatic carcinoma (avidin-biotin-peroxidase complex staining. Original magnifications: 100x (a), and 400x (b)).
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Immunohistochemistry examination found neoplastic cells positive for PSA (Figures 3(a) and 3(b)), Ki-67, and CD10 in a diffuse and >10% expression, while thyroid transcription, calponin, and thrombomodulin were negative.