PMC3264870_01
Endoscopic examination showed a pigmented elevated lesion in the posterior wall of the stomach
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Fig1
Gastroscopy showed a pigmented, elevated lesion, approximately 2 cm in diameter, in the posterior wall of the stomach (Fig. 1).
a Histology showed sheet-like malignant cells with large nuclei and eosinophilic cytoplasms containing dark brown pigment. b Tumor cells were positive for HMB-45 antibody. c Tumor cells were also positive for S-100 protein. a H&E, x400; b and c immunohistochemistry, x200
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Fig2
A biopsy was performed and histologic examination revealed sheet-like malignant cells with large nuclei and eosinophilic cytoplasms containing dark brown pigment (Fig. 2a). Immunohistochemically, the tumor cells were positive for S-100 proteins (Fig. 2b) and HMB-45 antibodies (Fig. 2c), and negative for pan-cytokeratin antibodies (AE1/AE3) and leukocyte common antigen.
FDG-PET showed accumulation of tracer in the gastric tumor (arrow). No accumulation was observed in any other site
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Fig3
Furthermore, F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) showed no accumulation of tracer, except in the tumor of the stomach (Fig. 3).
Surgical specimen from the distal gastrectomy. a There was a tumor in the posterior wall of the stomach. b The tumor was 2.0 x 1.9 x 0.9 cm in size
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Fig4
The resected specimen contained a brown-pigmented fungiform tumor, 2 cm in diameter, in the posterior wall of the stomach (Fig. 4).
a Resected subcutaneous tumor. b Histological examination revealed sheet-like malignant cells similar to those in the tumor of the stomach. H&E, x200
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Fig5
A subcutaneous tumor in his back was resected and pathological examination revealed a metastasis of MM (Fig. 5).