case_images: PMC9480177_01
case_images: A dome-shaped nodule, measuring 4cmx4cm on the left back (A). Purplish red and firm, with ulceration and hemorrhagic crust (B).
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case_images: PMC9480177_01_CCID-15-1869-g0001.jpg
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case_images: The skin lesion was purplish red and firm, with ulceration and hemorrhagic crust (Figure 1).
case_images: Skin biopsy revealed tumor cells infiltrate in the dermis with extensive necrosis. The tumor cells had abundant and light staining cytoplasm, clear nucleolus, and obvious atypia (H&E, magnification: x200) (A). Immunohistochemical stain highlighted the tumor cells, showing CK-7 (B), TTF-1 (C) and Vimentin (D) positive (magnification: x200).
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case_images: PMC9480177_01_CCID-15-1869-g0002.jpg
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case_images: The tumor cells had abundant and light staining cytoplasm, clear nucleolus, and obvious atypia (Figure 2A). TTF-1 and vimentin (Figures 2B-D), and negative for CK20 and CD5/6. The proliferative index, as measured by Ki-67, was over 90% of tumor cells.