PMC6424055_01
Clinical presentation of the tumor.
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The lesion appeared to invade the clavicle bone and cervical lymphnodes were not palpable (Fig. 1).
Intraoperative view of the deep aspect of the tumor invading the clavicle bone.
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Intraoperative view of the harvesting of two fasciocutaneous flaps.
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The wound closed by layers at the end of the surgical procedure.
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Dermal infiltration by neoplastic proliferation with pushing margins (A); this neoplastic proliferation has a solid, trabecular and pseudoglandular growth pattern (B), with focal areas of comedonecrosis and extensive areas of coagulative necrosis and hemorragia (C); the tumor cells are large with abundant eosinophilic cytoplasm and nuclei with finely dispersed chromatin and prominent nucleoli, there are many atypical mitotic figures (D). Hematoxylin-eosin stain.
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Punch biopsy came back positive for moderately differentiated adenocarcinoma composed by cells with abundant cytoplasm, nuclei with dispersed chromatin and prominent nucleoli. Hematoxylin-eosin stain.
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A punch biopsy was performed that came back positive for moderately differentiated adenocarcinoma composed by cells with abundant cytoplasm, nuclei with dispersed chromatin and prominent nucleoli (Fig. 7) positive stain CK AE1-AE3 and CDX2 (Fig. 8).