A 78-year-old woman was referred to our clinic with constipation associated with significant weight loss over the previous 7 months. A colonoscopy was performed showing a 12 cm diameter tumor in the sigmoid colon. A computerized tomography of the abdomen and pelvis confirmed the presence of a bilobular lesion in the sigmoid colon, and also showed a nodular hepatic metastasis in III hepatic segment, a lesion in each ovarium suggesting a bilateral Krukenberg’s tumor and peritoneal effusion. A surgery with palliative intention was performed removing as much of the tumor and metastases as possible. Chemotherapy after surgery was initiated (using capecitabine plus oxaliplatin) and the patient was given a prognosis of no more than 3 months of life expectancy. Two months after surgery, the patient was referred to our department with a skin lesion around the umbilicus. It grew slowly with no local symptoms. Clinical examination revealed a 6 cm, erythematous to violaceous, nontender, smooth, uniform, and fixed mass (Fig. 1a). A punch biopsy was performed, which demonstrated cutaneous metastasis of a low-differentiated adenocarcinoma (Fig. 1b). Immunohistochemical techniques were needed to clarify the primary tumor as the hematoxylin eosin stain did not provide any clue. These techniques showed positivity in tumoral cells to CK 7, WT1, vimentine, estrogen receptor, progesterone receptor, and CD 10, with negativity for CK 20 (Fig. 1c,d), and concluded not colon primary tumor, but ovarian tumor. As the patient was in good condition overall, previous chemotherapy was changed to another more specific regimen for ovarian cancer: taxol and carboplatin. Six cycles have been completed and the patient is still alive with regular follow-up.