Neuroendocrine carcinoma of the pancreas with soft tissue metastasis

Figure 1 A computed tomography scan revealed a low-density heterogeneous mass of 81 mm × 68 mm in size in the tail of the pancreas (arrow) that invaded the greater curvature of the stomach and the spleen.

Figure 2 Pathology of the pancreas. A: Spindle-shaped cells with scanty cytoplasm and hyperchromatic nuclei (hematoxylin and eosin staining); B: Positively stained for chlorhexidine A; C: Approximately 80% of the tumor cells were positively stained for Ki67; D: Tumor cells were positively stained for synaptophysin (B, C and D: EnVision) (original magnification: ×200 and ×400).

Figure 3 Positron emission tomography-computed tomography revealed high fludeoxyglucose uptake in the left leg and the relapse of carcinoma in both hila of the lungs.

Figure 4 Pathology of the leg. A: Tumor cells displayed infiltrative growth in the striated muscle of the left leg [hematoxylin and eosin (HE) staining, original magnification: ×100]; B: Tumor cells were homogeneous (HE staining, original magnification: ×400); C: Tumor cells were positively stained for synaptophysin (EnVision, original magnification: ×400).