PMC6929939_01
Representative photograph of the patient's erythema at presentation before (A) and after (B) surgery. The skin erythema reappeared and Comment: gradually become serious at 10 days after surgery (C-E). The skin rash on the face of the patient has disappeared, and the pigmentation remained on the skin of the legs on the 27th day of treatment with octreotide+chemotherapy (F-H).
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A 46-year-old male patient was admitted to the hospital who presented with systemic repeated erythema with pruritus and local necrosis (Figure 1).
On March 25, 2019, abdominal CT showed a mass (4.2*3.5cm) in the tail of pancreas, and multiple liver nodules were observed (A, B). Abdominal enhanced CT showed multiple liver nodules (C, May 2019). On October 10, 2019, the patient underwent transcatheter arterial chemoembolization with local anesthesia (D).
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Subsequently, the patient went to our hospital for abdominal CT examination again, and similar imaging results were found (Figure 2).
Positive expression of CgA (A), Syn (B), SSTR2 (C), and glucagon (D) in primary tumor tissue. The Ki-67 index was 5~10% (E) and 25~30% (F) in the primary tumor and liver metastases, respectively.
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The results of immunohistochemistry in primary tumor showed that the expression of PCK, EMA (weak), CgA, Syn, CD56, Vim and glucagon was positive, and the positive rate of Ki-67 (MIB-1) was 5~10% (Figure 3).