case_images: PMC9195103_01
case_images: Computed tomography of the chest, abdomen, and pelvis.
case_images: jchimp-12-01-083f1.jpg
case_images: PMC9195103_01_jchimp-12-01-083f1.jpg
case_images: f1-jchimp-12-01-083
case_images: A repeat CT chest, abdomen, and pelvis revealed multiple lytic lesions in the left clavicle, with possible fracture, as well as in the sacrum and ilium (Fig. 1).
case_images: Immunohistochemistry of bone marrow aspirate.
case_images: jchimp-12-01-083f2.jpg
case_images: PMC9195103_01_jchimp-12-01-083f2.jpg
case_images: f2-jchimp-12-01-083
case_images: The immunohistochemistry (Fig. 2 and Table 2) was positive for synaptophysin, pancytokeratin, patchy chromogranin, CDX2, and villin, the combination of which supported the diagnosis of metastatic, high-grade, poorly differentiated neuroendocrine carcinoma (NEC) favoring a gastrointestinal pancreaticobiliary origin, invading the majority of the bone marrow.