PMC4782650_01
Erythematous purpuric plaque, infiltrated, located in the infraumbilical
midline scar and two erythematous-wine colored nodules in the midline,
suprapubic region; the black arrow marks the biopsied nodule. Suprapubic
cystostomy with urine leakage
abd-91-01-0073-g02.jpg
PMC4782650_01_abd-91-01-0073-g02.jpg
f02
At the dermatological examination were observed: an infraumbilical scar, an erythematous-purpuric plaque, infiltrated, measuring about 10 x 5 cm at the hypogastrium, fistula with urine drainage at midline, infraumbilical region and two erythematous-wine colored nodules at midline, suprapubic region (Figure 2).
Tomography of abdomen and pelvis: (a) Cut at bladder level, thickening of
right vesical wall associated with densification of adjacent fat and
mass of heterogeneous enhancement infiltrating the abdominal wall up to
the epidermis (white arrows). Contrast excreted by the kidneys in the
interior of the bladder (dotted arrow); (b) Cut below the pubic
symphysis, showing extension of the same mass through the subcutaneous
tissue and the biopsied nodule (white arrow); (c) Cut at kidney level
showing free liquid (*) and peritoneal nodules, of irregular outline and
heterogeneous enhancement, suggestive of secondary implants (white
arrows).
abd-91-01-0073-g03.jpg
PMC4782650_01_abd-91-01-0073-g03.jpg
f03
Skin - Histopathologic findings: neoplasm composed predominantly of atypical
and pleomorphic epithelioid cells, disposed in large compact aggregates,
without any characteristic architecture. Presence of numerous mitoses and
areas of necrosis. The neoplasm occupies all the dermis (hematoxilin and
eosin staining; (A) 4x; (B) 10x; (C) 40x)
abd-91-01-0073-g04.jpg
PMC4782650_01_abd-91-01-0073-g04.jpg
f04
The neoplasm occupied the entire dermis (Figure 4).
Bladder - Histopathologic findings: neoplasm composed predominantly of
atypical and pleomorphic epithelioid cells, disposed in large compact
aggregates, without any characteristic architecture. Presence of numerous
mitoses and areas of necrosis. The neoplasm reaches the muscular wall
[hematoxilin and eosin staining; (A) 4x; (B) 10x; (C) 40x)].
abd-91-01-0073-g05.jpg
PMC4782650_01_abd-91-01-0073-g05.jpg
f05
A neoplasm reached the muscular layer (Figure 5).
Bladder - immunomarking profile: immunopositivity with anti vimentin
(diffuse) (A, 4x; B, 40x) and cytokeratin AE1/AE3 (rare cells) (C, 4x; D,
40x) antibodies
abd-91-01-0073-g06.jpg
PMC4782650_01_abd-91-01-0073-g06.jpg
f06
Skin - immunomarking profile: immunopositivity with anti vimentin (diffuse)
(A, 4x; B, 40x)
abd-91-01-0073-g07.jpg
PMC4782650_01_abd-91-01-0073-g07.jpg
f07