PMC3362226_01
a Abdominal distension with evident vascularization. b Soft edema (Godet sign) of lower members.
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F1
The abdomen was distended and with evident vascularization (fig. 1a). Soft edema (Godet sign) was present in the lower members (fig. 1b).
T2-sequence magnetic resonance imaging in the coronal plane showing the enlarged liver with several nodules with central hypersignal (white arrows).
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F2
T2-sequence magnetic resonance imaging in the coronal plane was performed, which revealed an enlarged liver, with several nodules with central hypersignal, suggestive of metastasis (fig. 2).
a Photomicrograph of liver biopsy showing the positive immunohistochemical reaction to carcinoembryonic antigen. b Photomicrograph of rectal biopsy with hematoxylin and eosin confirming the diagnosis of adenocarcinoma.
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F3
The liver biopsy confirmed infiltration by adenocarcinoma with several metastases (fig. 3a). The sigmoidoscopy evidenced an ulcerative-vegetative lesion 10.0 cm from the anal verge; the biopsy confirmed adenocarcinoma of the rectum (fig. 3b). The patient evolved with significant abdominal pain, hypotension and cardiopulmonary arrest.