case_images: PMC4782650_01
case_images: 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
case_images: abd-91-01-0073-g02.jpg
case_images: PMC4782650_01_abd-91-01-0073-g02.jpg
case_images: f02
case_images: 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).
case_images: 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).
case_images: abd-91-01-0073-g03.jpg
case_images: PMC4782650_01_abd-91-01-0073-g03.jpg
case_images: f03
case_images: 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)
case_images: abd-91-01-0073-g04.jpg
case_images: PMC4782650_01_abd-91-01-0073-g04.jpg
case_images: f04
case_images: The neoplasm occupied the entire dermis (Figure 4).
case_images: 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)].
case_images: abd-91-01-0073-g05.jpg
case_images: PMC4782650_01_abd-91-01-0073-g05.jpg
case_images: f05
case_images: A neoplasm reached the muscular layer (Figure 5).
case_images: Bladder - immunomarking profile: immunopositivity with anti vimentin
  (diffuse) (A, 4x; B, 40x) and cytokeratin AE1/AE3 (rare cells) (C, 4x; D,
  40x) antibodies
case_images: abd-91-01-0073-g06.jpg
case_images: PMC4782650_01_abd-91-01-0073-g06.jpg
case_images: f06
case_images: Skin - immunomarking profile: immunopositivity with anti vimentin (diffuse)
  (A, 4x; B, 40x)
case_images: abd-91-01-0073-g07.jpg
case_images: PMC4782650_01_abd-91-01-0073-g07.jpg
case_images: f07