PMC3535726_01
Photograph of the patient skin. It shows multiple cafe- au- lait macules on the anterior arm side (a) back of 5 x 3 cm and buttocks (b).
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On his skin, there were multiple cafe-au-lait spots and areas of hyperpigmentation (Figures 1(a) and 1(b)).
The brain CT. Parietotemporal tumor and intraparenchymal hemorrhage associated left ventricular drainage system and midline shift (a) and after resection demonstrates no residual tumor and a resolve mass effect (b). Histopathology shows high mitotic index and multinucleated giant cells. Hematoxylin and eosin stain (c). Immunohistochemistry confirmed the glial origin and high proliferation rate and PAFG positive (d).
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He underwent left parietotemporal craniotomy, gross total resection of the tumor, and abscess drainage (Figures 2(a) and 2(b)). Immunohistochemistry confirmed the glial origin and high proliferation rate. (PFAG positive, high Ki-67 index) (Figures 2(c) and 2(d)).
Colon endoscopy demonstrates tubulovillous adenomatous polyps, a sessile polyp 40 mm with adenomatous aspect in rectum (a) and in sigmoid colon (b).
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Some of the lesions found during colon endoscopy were tubulovillous adenomatous polyps with high-grade dysplasia (Figures 3(a), 3(b), and 3(c)).
IHC evaluation of complex protein expression MMR. Reactivity was observed in the presence of brown coloration in this case there is not involvement of the MLH1 protein, while exhibiting an alteration in the expression of proteins MSH2 and MSH6 as seen in the images of blue coloration polyp 1.
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HMSH2 and HMSH6 protein expression, which were evaluated by immunohistochemistry (Figure 4). HMLH expression was preserved.