PMC5107736_01
Biopsy showed an infiltrating poorly differentiated adenocarcinoma with signet ring cell features (arrow) (A). After chemoradiation therapy, the surgical resection specimen showed an 8.5 cm tumor bed involved by residual infiltrating poorly differentiated adenocarcinoma invading into the muscularis propria (B) with no regional lymph nodes involvement. Chest wall metastasis (C) and excisional biopsy demonstrated a metastatic poorly differentiated adenocarcinoma with signet ring cell features (arrow) (D) morphologically consistent with the esophageal tumor.
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Barrett's esophagus and a fungating mass at the GE junction (Siewert II) nearly obstructing the lumen. Biopsies showed poorly differentiated adenocarcinoma with signet ring cell features (Fig. 1A). T2N0M0 with no involvement of the 19 lymph nodes examined and no evidence of lymphovascular invasion (Fig. 1B). Two months later he presented with shortness of breath and a palpable 7 cm mass cephalad to a left chest tube scar (Fig. 1C). The chest wall lesion was metastatic poorly differentiated adenocarcinoma morphologically similar to the patient's known esophageal cancer, also with signet cell features (Fig. 1D).
PMC5107736_02
Esophagectomy specimen showed a moderately differentiated adenocarcinoma (A). Punch biopsy of a subcutaneous metastasis found in the right temple revealed a moderate to poorly differentiated adenocarcinoma (B). Immunohistochemical profile showed tumor cells positive for cytokeratin 7 (C), carcinoembryonic antigen and mucicarmine (D), but negative for cytokeratin 20, thyroid transcription factor 1 and cluster of differentiation 31, consistent with a metastasis from the patient's known esophageal adenocarcinoma.
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T1bN0M0 with 23 lymph nodes negative for metastasis and an absence of lympho-vascular involvement (Fig. 2A). Two years later he presented with a tender subcutaneous mass measuring 2 x 2 x 1 cm on his right temple. Biopsy evidenced metastatic moderate to poorly differentiated adenocarcinoma with similar morphology to the original tumor and positive stains for carcinoembryonic antigen (CEA) and mucin, as well as cytokeratin 7 (CK7), confirming an upper gastrointestinal source (Fig. 2B-D).
PMC5107736_03
Biopsy of a gastroesophageal junction mass was confirmed to be a poorly differentiated adenocarcinoma, signet-ring type (A). Biopsy of a scalp mass three years later revealed a moderately to poorly differentiated adenocarcinoma (B) with tumor cells positive for villin (C) and cytokeratin 7 (D), but negative for cytokeratin 20, thyroid transcription factor 1, prostate specific antigen and thyroglobulin, consistent with an esophageal adenocarcinoma metastasis.
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Biopsy demonstrated poorly differentiated adenocarcinoma with focal signet ring cell features (Fig. 3A). It stained positive for Villin and CK7, indicating an upper GI source (Fig. 3B-D).