PMC6612022_01
CT Scans with IV contrast; (a) shows the axial view revealing a large polylobulated mass in the left abdomen, and (b) shows the sagittal view revealing a large mass occupying most of the left abdomen.
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Computed tomography (CT) of the abdomen and pelvis revealed a poly-lobulated mass in the left abdomen emanating from the left colon (Fig. 1). Moderate-to-large amount of stool in the proximal colon suggested constipation and partial obstruction (Fig. 1).
Resected Specimen shows (a) the left colon mass immediately upon resection measured at 20 x 23 cm, and (b) the resected tumor during analysis.
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Upon surgical intervention, the tumor extended through the colon wall with pericolonic hemorrhage (Fig. 2) arising from the mesocolon. The mass measured 7 cm in greatest dimension which on section was nodular and brown (Fig. 2, Fig. 3).
Neuroendocrine Carcinoma shows (a) the isolated spherical tumor obstructing the colon lumen, which is characteristic of neuroendocrine tumors, (b) the cells labeled with the synaptophysin stain at 100X, which strongly demonstrates neuroendocrine carcinoma, and (c) the proliferation marker Ki-67 labelling approaching 100%, which suggests malignant tissue with poorly differentiated tumor cells.
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The proliferation marker Ki-67 was stained and was almost 100% (Fig. 3).
Squamous Cell Carcinoma shows (a) the characteristic keratin pearls of squamous cell carcinoma in the tumor, (b) the squamous cells labeled with the cytokeratin marker 5/6 (CK 5/6) at 100X, (c) the squamous cells labeled with the P63 antibody marker at 40X, and (d) the squamous cells labeled with the CDX2 marker at 40X, which show intense positivity.
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The squamous cells were positive for cytokeratin marker 5/6 (CK5/6), P40 marker and P63 marker (Fig. 4). Interestingly they were also positive for CDX2 staining (Fig. 4), which indicates these cells have intestinal differentiation.