The biopsy specimen revealed an ulcerated neoplasm characterized by closely crowded glandular structures lined by 1 to 2 rows of atypical cuboidal epithelial cells with large pleomorphic and hyperchromatic nuclei with prominent nucleoli. There were scattered mitotic figures and individual cell necrosis. The lumina were filled with eosinophilic secretions. In a few foci, there were papillary projections into the lumina. The slides from the primary pancreatic adenocarcinoma revealed histologic features that were very similar to those seen in the cutaneous lesion. It was concluded that the toe lesion was most consistent with a metastasis from the pancreatic adenocarcinoma.
Solitary Hemorrhagic Nodule on the Great Toe—Diagnosis. Arch Dermatol. 2003;139(11):1497-1502. doi:10.1001/archderm.139.11.1497-a