case_images: PMC4769757_01
case_images: Necrolytic migratory erythema over the back with areas of healing and hyperpigmentation.
case_images: CRIS2016-1484089.001.jpg
case_images: PMC4769757_01_CRIS2016-1484089.001.jpg
case_images: fig1
case_images: Physical examination revealed an erythematous scaly rash with areas of hyperpigmentation and skin sloughing involving mainly the extremities and lower back (Figure 1).
case_images: Glossitis.
case_images: CRIS2016-1484089.002.jpg
case_images: PMC4769757_01_CRIS2016-1484089.002.jpg
case_images: fig2
case_images: Her tongue was atrophic and bright red (Figure 2).
case_images: Onychoschizia.
case_images: CRIS2016-1484089.003.jpg
case_images: PMC4769757_01_CRIS2016-1484089.003.jpg
case_images: fig3
case_images: Her nails were brittle with longitudinal and transverse fissuring (onychoschizia) (Figure 3).
case_images: Hypervascular tumor in the tail of pancreas with metastases in segment V of the liver.
case_images: CRIS2016-1484089.004.jpg
case_images: PMC4769757_01_CRIS2016-1484089.004.jpg
case_images: fig4
case_images: Abdominal ultrasound revealed a hypoechoic mass in the tail of pancreas with multiple hypoechoic liver lesions suggestive of metastatic disease Accordingly, a contrast enhanced CT scan was done and confirmed the presence of 5 x 5 cm hypervascular lesion in the tail of pancreases with 3 liver metastases (Figure 4).
case_images: Glucagonoma in the tail of pancreas.
case_images: CRIS2016-1484089.005.jpg
case_images: PMC4769757_01_CRIS2016-1484089.005.jpg
case_images: fig5
case_images: Distal pancreatectomy with splenectomy as well as wedge resection of a superficial liver lesion was performed (Figure 5).