PMC5851316_01
Sagittal US image of the lower abdomen obtained with a convex probe (1-6 Mhz). Large mass filled with gas (star), contacting the superior bladder wall (arrow), with focal thickening. Presence of free abdominal fluid is noted.
CRIRA2018-4935261.001.jpg
PMC5851316_01_CRIRA2018-4935261.001.jpg
fig1
It revealed a midline mass with a central gas-filled cavity contacting the superior bladder wall and extending to the anterior abdominal wall (Figure 1).
(a) 3D CT reconstruction showing an emaciated patient with a visible infraumbilical mass (arrow). Axial (b), coronal (c), and sagittal (d) contrast-enhanced CT images depicting a large and heterogeneous median abdominal mass, extending from the anterosuperior aspect of the bladder toward the umbilicus.
CRIRA2018-4935261.002.jpg
PMC5851316_01_CRIRA2018-4935261.002.jpg
fig2
Inferiorly it contacted the bladder dome, and anteriorly there was infiltration of the entire thickness of the anterior abdominal wall, invading the umbilicus (Figure 2).
Gross specimen of the tumor ((a) anterior view; (b) cross section), showing a multinodular mass with fistulization to the umbilical skin (black arrows) and involvement of the bladder wall (red arrow) and a central necrotic cavity (star). Histologic image of the resected tumor ((c) H&E 100x; (d) H&E 400x) showing areas with a mucinous pattern (blue star) and a signet ring cell morphology (blue arrow).
CRIRA2018-4935261.003.jpg
PMC5851316_01_CRIRA2018-4935261.003.jpg
fig3
It infiltrated the skin, as well as the colonic and bladder walls, with mucosa ulceration (Figure 3).
(a) Histologic image of the resected tumor (cytokeratin 34-beta-E12, 100x). Most of the neoplastic cells expressed high molecular-weight cytokeratins (black arrow). (b) Neoplastic cells showing diffuse membranous and cytoplasmic expression of beta-catenin (blue arrow). Note that there is no nuclei staining (beta-catenin, 400x).
CRIRA2018-4935261.004.jpg
PMC5851316_01_CRIRA2018-4935261.004.jpg
fig4
Radiologic-pathologic correlation of the tumor ((a) sagittal CT image; (b) cross section of the gross specimen), showing a large and heterogeneous mass, with thickened wall and central necrotic cavity.
CRIRA2018-4935261.005.jpg
PMC5851316_01_CRIRA2018-4935261.005.jpg
fig5