PMC5398111_01
(a) Erythematous to hyperpigmented infiltrated nodules and plaques, showing peau daeorange appearance. (b) Close up view
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F1
On examination, there were multiple skin-colored and erythematous papules coalesced to form plaques over lower abdomen, firm to hard in consistency, surrounding skin had a doughy feel [Figure 1].
(a) Low power: Dermis shows diffuse infiltration of tumor cells. Lymphoplasmacytic infiltrate around blood vessels. (b) High power: Dermal tumor cells are present in cords and singles, with pleomorphic round to oval nucleus, high N:C ratio, and vesicular chromatin. Signet ring-like cells are present
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F2
Biopsy of representative lesion showed diffuse infiltration of tumor cells in cords and singles, with pleomorphic round to oval nucleus, high N:C ratio and vesicular chromatin in the dermis, along with signet ring-like cells and lymphoplasmacytic infiltrate around blood vessels suggestive of metastatic poorly differentiated adenocarcinoma [Figure 2].
(a) Endoscopic view of gastroesophageal junction: Friable hypertrophic growth, which on biopsy showed features suggestive of poorly differentiated adenocarcinoma. (b) Endoscopic view of fundus of the stomach
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F3
Upper gastrointestinal (GI) endoscopy showed a friable hypertrophic growth at gastroesophageal junction, which on biopsy showed features suggestive of poorly differentiated adenocarcinoma [Figure 3].