PMC1779271_01
a) Imaging shows a well defined caecal tumour (arrow) with evidence of vertebral metastasis (arrowhead). b) The tumour is irregular in outline (arrow) and is closely approximated to the anterior abdominal wall.
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F1
CT scan of abdomen showed a caecal tumour with regional lymphadenopathy and vertebral metastasis (Figure 1).
a) Histology shows a well defined intraluminal, protuberant tumour invading the submucosa. This invasive tumour extends to pericolonic fibroadipose tissue. b) This tumour is positive with PSA, confirming its metastatic origin from a primary prostatic carcinoma.
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F2
Histopathological examination of the specimen showed a poorly differentiated adenocarcinoma of the caecum extending throughout the whole bowel wall and breaching the serosa with metastatic involvement of 5 of 15 paracolic lymph nodes (Figure 2). The possibility of prostatic metastasis was considered and confirmed on immunohistochemical staining for PSA (Figure 2) and, given this, stains for CK7, CK20 and CDX2 immunoprofile were considered unnecessary.