PMC2253526_01
Sagital schematic view of tumour recurrence in anterior abdominal wound complicated by two incisional hernias: A - incisional hernia 20 mm above umbilicus (30 mm diameter). B - incisional hernia 20 mm below umbilicus (40 mm diameter).
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F1
Thus it appeared as if it may be an isolated recurrence (Figure 1).
A and B) Photomicrograph showing malignant glands typical of adenocarcinoma lined by atypical cells with hyperchromatic nuclei. There is an increase in mitotic activity within the cells and the presence of necrotic material. Stained with haematoxylin & eosin. C) Immunohistochemistry with CK20 showing tumour cell cytoplasm stained. D) Immunohistochemistry with CDX2 staining showing prominent nuclei of tumour cells. CK20 and CDX2 are consistent with cells of colorectal origin. Note: Original magnifications a - d 20x.
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F2
Subsequent immuno-histochemistry was positive for CK20 and CDX2 and negative for CK7 (Figure 2).
CT scan of abdomen showing soft tissue mass in the anterior abdominal wall (white arrow). The ventral incisional hernia is seen on this slice and was arising cranially but lies superiorly to the mass.
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F3
On review of the scans, a 3.6 x 1.6 cm nodule was seen in the midline on the anterior abdominal wall just inferior to the hernia (Figure 3).