PMC9763888_01
(A-C) T1- and T2-weighted MRI scans demonstrating multiple ventricular T2 hypersignal and T1 hypointense cystic lesions in the right buttock tissue and sacrococcygeal region. (D) T2-weighted gadolinium-enhanced MRI scans demonstrating annular enhancement of the cystic wall, but no enhancement of the cystic part of the lesion.
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Annular enhancement of the cystic wall was observed on the T2-weighted gadolinium-enhanced MRI scans ( Figure 1 ).
Resected lump specimens (4 cm x 3 cm).
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Surgical resection was performed again, and a mass of about 4 cm x 3 cm was removed ( Figure 2 ). Immunohistochemical staining of SATB2 and CDX2 in the cyst epithelial cells showed strong nuclear staining ( Figures 2E, F ).
Histopathological features of malignant transformation of EC. (A, B) Cuboid columnar epithelium on smooth muscle tissue of cyst wall. (C) Focal cyst wall shows adenocarcinoma with interstitial invasion, and cancer tissue breaks through the basement membrane and invades the interstitium. (D) In the lesion area, glands of different sizes and disorderly arrangement can be seen, and the cancer cells are irregular in shape, different in size, and different in nuclear staining. (E, F) Immunostaining indicated positivity for CDX2 (E) and SATB2 (F) (original magnification: (B, D) x200; (A, C, E, F) x100).
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The final histological diagnosis was EC with locally moderately differentiated adenocarcinoma ( Figure 3 ). Outside the cyst wall is fibrous connective tissue and smooth muscle ( Figures 3A, B ). Local cancerous lesions showed glands of different sizes and disorderly arrangement ( Figures 3C, D ).