PMC5902105_01
Groin skin. (a) Hematoxylin and eosin: within the dermis, there are clusters of large tumor cells with pleomorphic nuclei. (b) Cytokeratin stain highlights the tumor cells.
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fig1
A biopsy was performed in 2016 and revealed EMPD (Figures 1(a) and 1(b)).
MRI of the thoracic and lumbar spine: compression vertebral fracture at L4 with retropulsion of the posterior vertebral body causing severe spinal stenosis. Extraosseous extension of tumor into ventral epidural space at T12.
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fig2
T12 (Figure 2). The patient's symptoms progressed despite surgical intervention, conventional radiation therapy to T12 lesion, and stereotactic body radiation therapy to L4 lesion.