PMC3891164_01
A firm subcutaneous nodule is noted on the right forearm.
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F1
Two firm, 1.0 cm, subcutaneous nodules were noted on the physical examination (Figure 1).
Light microscopic findings. (A) Excisional biopsy from forearm shows metastatic adenocarcinoma involving the subcutis (H&E stain, x100). (B) High power view shows well formed tubules and strands of adenocarcinoma cells with fibroplasia (H&E stain, x200)
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F2
The histology revealed neoplastic gland cords or nests in the desmoplastic stroma, and this was consistent with metastatic adenocarcinoma (Figure 2).
Abdomen computed tomography shows a low density mass in the tail of the pancreas along with multiple liver metastases.
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F3
The abdominal computed tomography (CT) detected a low-density mass located in the tail of the pancreas along with multiple liver metastases (Figure 3).
(A) There are PAS positive droplets in the lumen of neoplastic glands (PAS stain x400). (B, C) The neoplastic glands are positive for CK 7 and CK 19 immunostaining (x400). (D) The tumor cells were negative for TTF immunostaining (x400).
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F4
The immunohistochemical staining of the skin biopsy showed a positive reaction to monoclonal antibodies for CK 7, CK 19 and thyroid transcription factor (TTF), and these markers are normally present in adenocarcinoma of the lung (Figure 4).