case_images: PMC3891164_01
case_images: A firm subcutaneous nodule is noted on the right forearm.
case_images: kjim-20-260-g001.jpg
case_images: PMC3891164_01_kjim-20-260-g001.jpg
case_images: F1
case_images: Two firm, 1.0 cm, subcutaneous nodules were noted on the physical examination (Figure 1).
case_images: Light microscopic findings. (A) Excisional biopsy from forearm shows metastatic adenocarcinoma involving the subcutis (H&E stain, x100). (B) High power view shows well formed tubules and strands of adenocarcinoma cells with fibroplasia (H&E stain, x200)
case_images: kjim-20-260-g002.jpg
case_images: PMC3891164_01_kjim-20-260-g002.jpg
case_images: F2
case_images: The histology revealed neoplastic gland cords or nests in the desmoplastic stroma, and this was consistent with metastatic adenocarcinoma (Figure 2).
case_images: Abdomen computed tomography shows a low density mass in the tail of the pancreas along with multiple liver metastases.
case_images: kjim-20-260-g003.jpg
case_images: PMC3891164_01_kjim-20-260-g003.jpg
case_images: F3
case_images: The abdominal computed tomography (CT) detected a low-density mass located in the tail of the pancreas along with multiple liver metastases (Figure 3).
case_images: (A) There are PAS positive droplets in the lumen of neoplastic glands (PAS stain x400). (B, C) The neoplastic glands are positive for CK 7 and CK 19 immunostaining (x400). (D) The tumor cells were negative for TTF immunostaining (x400).
case_images: kjim-20-260-g004.jpg
case_images: PMC3891164_01_kjim-20-260-g004.jpg
case_images: F4
case_images: The immunohistochemical staining of the skin biopsy showed a positive reaction to monoclonal antibodies for CK 7, CK 19 and thyroid transcription factor (TTF), and these markers are normally present in adenocarcinoma of the lung (Figure 4).