PMC10294269_01
a Pathology slides visualized at x40 (H&E stain from biopsy). b Immunohistochemical stain positive for SOX-10. c S100-positive stain. d Negative control.
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F1
Immunohistochemistry found the mass positive for SOX10, Melan-A, HMB45, and CD117 but negative for S100 (Fig. 1).
PET scan images. a Necrotic portacaval nodal conglomerate. b Retroperitoneal lymphadenopathy in the aortocaval space. c Heterogenous enhancing rectal mass involving the mesorectal fat, fascia, and anal sphincter with scattered colonic diverticuli.
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F2
A PET scan after the biopsy confirmed the mass and metastases to the surrounding mesorectal lymph nodes, in addition to innumerable hypermetabolic foci in the liver with some demonstrating central necrosis, three metastatic lung nodules, and metastatic bone lesions in the T7 spine, left posterior iliac bone, and right sacrum (Fig. 2).