PMC6477463_01
The right axillary skin appearance. Small reddish nodules were noted at the same site as the synchronous cutaneous metastasis.
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F1
After 6 years, the patient became aware of small, slowly growing reddish nodules on the scar of the primary surgery in his right axilla (Fig. 1).
Computed tomography imaging. Irregular thickening of the right axillary skin was noted.
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F2
Computed tomography revealed irregular thickening of the right axillary skin (Fig. 2), and no other signs of recurrence including lungs and the abdomen were observed.
Histopathological findings of the metachronous cutaneous metastasis of the right axillary skin. a Moderately to poorly differentiated adenocarcinoma with proliferation of atypical epithelium forming ductal and nest-like structure, showing similarity to the tissues of gastric cancer resected 6 years ago. HE. x100. b-d Immunohistochemical staining was positive for CK7 (c), and negative for CDX-2 (b) and CK20 (d).
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F3
Histopathological examination revealed moderately to poorly differentiated adenocarcinoma with proliferation of atypical epithelium forming ductal and nest-like structures, and immunohistochemistry showed CK7 positivity, CK20 negativity, CDX-2 negativity (Fig. 3).
Histopathological findings of the gastric cancer (a) and the synchronous cutaneous metastasis of the right axillary skin (b) resected 6 years ago. a, b Moderately to poorly differentiated adenocarcinoma was observed. Immunohistochemical staining was positive for CK7 and negative for CDX-2 and CK20 (not shown). HE. x100.
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F4
The histological appearance and the immunohistochemistry were identical to the tissues of the gastric carcinoma and the synchronous cutaneous metastasis resected 6 years ago (Fig. 4); therefore, a diagnosis of solitary late cutaneous metastasis from gastric cancer was made.