Skin metastasis of biliary cancer.

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A 81-year-old man noticed red papules and subcutaneous tumors on his face and trunk about 2 months ago. He had biliary system cancer about 1 year ago and received conservative therapy. The tumors were well-demarcated, 7 to 15mm in diameter with crust on its surface. The specimen had been obtained from the right postauricular subcutaneous tumor.On light microscopic findings, tumorr cells were observed in the dermis and subcutaneous tissue. There were variously sized glands lined by columnar cells. The lumina contained a various amounts of mucinous material. Various atypical tumor cells were also seen.On electron microscopic findings, in tumorr cells, small intracytoplasmic lumina lined by microvilli were observed. Cell organelles such as mitochondria and rough endoplasmic reticula had relatively increased in number.Immunohistochemical examination showed that tumor cells were positive for keratin, EMA, CEA and CA19-9.From these findings, the characteristics of tumor cells resembled that of the epithelium of biliary system. It was difficult to determine whether the tumor arose from the bile duct or from the gallbladder.
日本皮膚悪性腫瘍学会の論文