PMC4560142_01
CT demonstrating a large abdominal wall abscess containing air. There was no apparent connection between the abdominal wall abscess and the abdominal cavity, although the wall of the ascending colon adjacent to the abscess was thickened
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Fig1
Emergent CT was performed and demonstrated a large abdominal wall abscess of 15 x 12 cm in size, which contained a moderate amount of air (Fig. 1).
Colonoscopy revealing an ulcerated irregular tumor in the cecum
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Fig2
An ulcerated irregular tumor was found in the cecum (Fig. 2).
CT performed 39 days after the initial surgery demonstrating a mass that had originated from the ascending colon and had invaded the abdominal wall
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Fig3
At this time, a CT scan showed a mass that originated from the cecum that invaded into the abdominal wall at the exact site where the wall thickening had been pointed out before the first operation (Fig. 3).
Resected specimen. En bloc resection was carried out for carcinoma of the cecum with abdominal wall invasion (black arrow)
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Fig4
Oncological right hemicolectomy with partial abdominal wall resection was performed with macroscopically curative intent (Fig. 4).
Immunohistochemical study using D2-40, revealing invasion of carcinoma cells into the lymphatic channels of the skin
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Fig5
Detailed examination of the skin proved the presence of multiple sites of lymphatic invasion (Fig. 5).
CT demonstrating an enlarged lymph node of 3 cm in diameter in the right axillary region (white arrow)
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Fig6
Two months after the hemicolectomy, a CT was done for the sake of surveillance, and an enlarged lymph node of 3 cm in diameter was detected in the right axillary region (Fig. 6).
Histological examination of the enlarged right axillary lymph node, proving the presence of metastatic adenocarcinoma
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Fig7
Excisional biopsy of this axillary lymph node was done, and histological examination revealed metastatic adenocarcinoma (Fig. 7).