case_images: PMC6188187_01
case_images: The tumor cells showing large nuclei with dark staining.. Notes: The chromatin was thick, and the nucleoli were obvious. Pathological mitosis was observed with less cytoplasm. The tumor cells showed infiltrating growth in lumps, nests, and glandular tubules. H&E x100 magnification.
case_images: ott-11-6625Fig1.jpg
case_images: PMC6188187_01_ott-11-6625Fig1.jpg
case_images: f1-ott-11-6625
case_images: Observations by microscopy were as follows: in the subcutaneous tissue, the tumor cells had large nuclei with dark staining; the chromatin was thick, and the nucleoli were obvious; pathological mitosis was shown with less cytoplasm; the tumor cells were arranged in lumps, nests, and glandular tubules in small amounts with necrosis in small amounts (Figure 1).
case_images: Infiltration of cancer tissue in the dermis of the skin.. Note: H&E x100 magnification.
case_images: ott-11-6625Fig2.jpg
case_images: PMC6188187_01_ott-11-6625Fig2.jpg
case_images: f2-ott-11-6625
case_images: Invasive growth of the tumor tissue was observed, and its boundary was unclear; the infiltration reached the subcutaneous fibrous connective tissue and the superficial skin (Figure 2), invading the vessels and nerves.
case_images: ER of the cancer cell nuclei (100% strong positive); envision method x100 magnification.
case_images: ott-11-6625Fig3.jpg
case_images: PMC6188187_01_ott-11-6625Fig3.jpg
case_images: f3-ott-11-6625
case_images: The pathological diagnosis was grade II infiltrating ductal carcinoma derived from the accessory mammary gland (abdominal wall) with neuroendocrine characteristics, with the immunohistochemistry of ER (100% strong positive), PR (100% strong positive), HER-2 (-), ki67 (40% positive), Syn (+),CgA (+), and GCDFP15 (+) (Figures 3-9).
case_images: PR of the cancer cell nuclei (100% strong positive); envision method x100 magnification.
case_images: ott-11-6625Fig4.jpg
case_images: PMC6188187_01_ott-11-6625Fig4.jpg
case_images: f4-ott-11-6625
case_images: The pathological diagnosis was grade II infiltrating ductal carcinoma derived from the accessory mammary gland (abdominal wall) with neuroendocrine characteristics, with the immunohistochemistry of ER (100% strong positive), PR (100% strong positive), HER-2 (-), ki67 (40% positive), Syn (+),CgA (+), and GCDFP15 (+) (Figures 3-9).
case_images: HER-2 negative; envision method x100 magnification.
case_images: ott-11-6625Fig5.jpg
case_images: PMC6188187_01_ott-11-6625Fig5.jpg
case_images: f5-ott-11-6625
case_images: The pathological diagnosis was grade II infiltrating ductal carcinoma derived from the accessory mammary gland (abdominal wall) with neuroendocrine characteristics, with the immunohistochemistry of ER (100% strong positive), PR (100% strong positive), HER-2 (-), ki67 (40% positive), Syn (+),CgA (+), and GCDFP15 (+) (Figures 3-9).
case_images: Ki67 of the cancer cell nuclei (40%, strong positive); envision method x100 magnification.
case_images: ott-11-6625Fig6.jpg
case_images: PMC6188187_01_ott-11-6625Fig6.jpg
case_images: f6-ott-11-6625
case_images: The pathological diagnosis was grade II infiltrating ductal carcinoma derived from the accessory mammary gland (abdominal wall) with neuroendocrine characteristics, with the immunohistochemistry of ER (100% strong positive), PR (100% strong positive), HER-2 (-), ki67 (40% positive), Syn (+),CgA (+), and GCDFP15 (+) (Figures 3-9).
case_images: Syn of the cancer cell cytoplasm (diffuse positive); envision method x200 magnification.
case_images: ott-11-6625Fig7.jpg
case_images: PMC6188187_01_ott-11-6625Fig7.jpg
case_images: f7-ott-11-6625
case_images: The pathological diagnosis was grade II infiltrating ductal carcinoma derived from the accessory mammary gland (abdominal wall) with neuroendocrine characteristics, with the immunohistochemistry of ER (100% strong positive), PR (100% strong positive), HER-2 (-), ki67 (40% positive), Syn (+),CgA (+), and GCDFP15 (+) (Figures 3-9).
case_images: CgA of the cancer cell cytoplasm (diffuse positive); envision method x200 magnification.
case_images: ott-11-6625Fig8.jpg
case_images: PMC6188187_01_ott-11-6625Fig8.jpg
case_images: f8-ott-11-6625
case_images: The pathological diagnosis was grade II infiltrating ductal carcinoma derived from the accessory mammary gland (abdominal wall) with neuroendocrine characteristics, with the immunohistochemistry of ER (100% strong positive), PR (100% strong positive), HER-2 (-), ki67 (40% positive), Syn (+),CgA (+), and GCDFP15 (+) (Figures 3-9).
case_images: GCDFP15 of the cancer cell cytoplasm (diffuse positive); envision method x200 magnification.
case_images: ott-11-6625Fig9.jpg
case_images: PMC6188187_01_ott-11-6625Fig9.jpg
case_images: f9-ott-11-6625
case_images: The pathological diagnosis was grade II infiltrating ductal carcinoma derived from the accessory mammary gland (abdominal wall) with neuroendocrine characteristics, with the immunohistochemistry of ER (100% strong positive), PR (100% strong positive), HER-2 (-), ki67 (40% positive), Syn (+),CgA (+), and GCDFP15 (+) (Figures 3-9).
case_images: CT on March 15, 2017, shows the enlarged inguinal lymph nodes (red arrows) and enlarged lymph nodes around the iliac vessels (blue arrows).. Abbreviation: CT, computed tomography.
case_images: ott-11-6625Fig10.jpg
case_images: PMC6188187_01_ott-11-6625Fig10.jpg
case_images: f10-ott-11-6625
case_images: On March 15, 2017, as shown in Figure 10, CT showed postoperative changes on the right lower abdominal wall; the structure of the surgical area was disordered, and the skin was slightly thicker, with a subcutaneous patchy high-density shadow; a few lymph nodes were observed near the bilateral groin and iliac vessels; and some patchy low lesions were uneven in their internal density, including a large lesion ~1.7 x 2.3 cm in size.
case_images: CT on May 18, 2017, shows the enlarged inguinal lymph nodes (red arrows) and enlarged lymph nodes around the iliac vessels (blue arrows).. Abbreviation: CT, computed tomography.
case_images: ott-11-6625Fig11.jpg
case_images: PMC6188187_01_ott-11-6625Fig11.jpg
case_images: f11-ott-11-6625
case_images: On May 18, 2017, as shown in Figure 11, the CT reexamination revealed shrinkage of several enlarged lymph nodes around the bilateral groin and iliac vessels and some patchy low lesions with uneven internal density, including a large lesion ~2.0 x 1.4 cm in size.
case_images: CT on August 1, 2017, shows the enlarged inguinal lymph nodes (red arrows) and enlarged lymph nodes around the iliac vessels (blue arrows).. Abbreviation: CT, computed tomography.
case_images: ott-11-6625Fig12.jpg
case_images: PMC6188187_01_ott-11-6625Fig12.jpg
case_images: f12-ott-11-6625
case_images: August 1, 2017, as shown in Figure 12, showed that multiple lymph nodes near the bilateral groin and iliac vessels were smaller than before, and some of them had low-density necrosis, with the largest one ~1.7 x 1.2 cm in size. As of this writing, the patient is in stable condition.