PMC4772623_01
Left: gross picture of the sebaceous carcinoma of the back. Right: histology confirming sebaceous carcinoma with free margins.
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F1
A 56-year-old Ghanaian male with a medical history of hypertension presented to the emergency department complaining of fatigue, hematochezia, and back pain from a 7 x 7 x 4.2 cm exophytic, cauliflower-shaped, malodorous mass on his mid-thoracic back that increased in size over a period of 4 months (fig. 1a). The back mass was excised, and pathology revealed sebaceous carcinoma with free margins (fig. 1b).
Left: CT of the abdomen demonstrating a 9-cm mass in the ascending colon. Right: irregular wall thickening and heterogeneity in the rectum (arrow).
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F2
CT of the abdomen showed a 9-cm segment of mass-like thickening involving the ascending colon (fig. 2a), as well as irregular wall thickening and heterogeneity in the rectum (fig. 2b).
Histology demonstrating microsatellite instability in MSH2 and MSH6.
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F3
All three tumors demonstrated microsatellite instability in MSH2 and MSH6 (fig. 3).