These results, combined with the positive CDX2, villin, and SATB2 found in the lymph node, supported the diagnosis of metastatic anal adenocarcinoma, with the pagetoid spread being a cutaneous extension of the adenocarcinoma. The overall timeline of the diagnostic tests and procedures performed to reach this conclusion can be found in Figure 5. The gene discussed is SATB2; the disease is adenocarcinoma.