PMC9957569_01
Panel A shows the prominent appendiceal orifice seen at colonoscopy. Panel B depicts a normal appendiceal orifice.
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FIG1
At colonoscopy, a slightly prominent appendiceal orifice was biopsied (Figure 1), the histology of which returned as poorly differentiated carcinoma favouring a gynaecological tract origin with immunohistochemistry positive for WT1 and PAX8.
CT scan demonstrating progressive peritoneal disease and a developing small bowel obstruction. Panel A demonstrates the close association of the peritoneal disease with the right ovary and panel B shows the developing small bowel obstruction.
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FIG2
Repeat CT imaging showed that this was secondary to progression of peritoneal disease with new involvement the right ovary (Figure 2) leading to the provisional impression of a primary right ovarian carcinoma.
PET/CT before (A) and after (B) neoadjuvant chemotherapy showing near complete response. Arrows indicate PET-avid lesions.
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FIG3
A repeat fluorodeoxyglucose (FDG)-positron emission tomography and CT scan (FDG PET/CT) showed only two areas of residual omental deposits (<15mm) compared to the pre-chemotherapy imaging (Figure 3).