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MRI imaging of tumor (T1-weighted (a), T2-weighted (b), and diffusion-weighted (c) images).
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Akita University Hospital on December 2009 with a history of progressive difficulty with defecation. Abdominal ultrasound (US), abdominal computed tomography (CT) images, and magnetic resonance images (MRIs) revealed a tumor with a maximum diameter of 5.5 cm, occupying the whole cavity of pelvis minor, within the posterior wall of the lower rectum (Figure 1).
Endoscopic (a, b) and EUS (c) findings.
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Colonoscopy revealed no mucosal findings except a submucosal mass (Figure 2).
18FDG-PET/CT imaging prior to Ima treatment (a, b) and 1 month after treatment (c, d).
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Endoscopic US examinations revealed a low-echoic and irregular pattern in the tumor. 18FDG-PET showed marked increased uptake in the rectal tumor (Figure 3(a)). SUV-max decreased to that of the background level, and the sum of the largest diameter of the tumor to 71% of baseline (Figure 3(c)).
Histopathological analysis of the tumor: (a) HE, (b) CD117, (c) CD34, and (d) Ki-67.
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The other part mainly contained spindle-type cells that showed positive staining with CD117 (c-KIT) and CD34, (Figures 4(a), 4(b), and 4(c)). Almost no mitotic figures and very low Ki-67 positivity (0.1%) was observed (Figure 4(d)).