PMC5340933_01
Intraoperative view.
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fig1
The surgical approach adopted was a pelvic exenteration with anterior resection of the abdominal rectum and navel, with pelvic lymphadenectomy and ureteroileostomy of Bricker (Figure 1).
Macroscopic aspects: (a) superior view; (b) sagittal section.
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Uterus and ovaries were unchanged (Figure 2).
Histologic features of the tumor: (a) urothelium surface; (b) glandular differentiation; (c) areas of lesser differentiation.
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fig3
The histology revealed an adenocarcinoma of enteric type with poorly differentiated areas and areas with focal mucinous differentiation (Figure 3).
Immunostains: (a) CK20 positive staining in the tumor and negative staining in the overlying urothelium; (b) CK7 negative staining in the tumor and positive staining in the urothelium.
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fig4
The immunostains revealed cytokeratin 20 (CK20) and CDX2 expression, absence of expression for cytokeratin 7 (CK7) and cytokeratin 34betaE12 (34betaE12), and only focal nuclear staining for beta-catenin (Figures 4 and 5).
Immunostains: (a) CDX2 positive staining in the tumor; (b) beta-catenin negative nuclear staining in the majority of the tumor.
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fig5
The immunostains revealed cytokeratin 20 (CK20) and CDX2 expression, absence of expression for cytokeratin 7 (CK7) and cytokeratin 34betaE12 (34betaE12), and only focal nuclear staining for beta-catenin (Figures 4 and 5).