PMC1190221_01
A T2-weighted axial MR image of the pelvis showing an irregular presacral fluid collection (arrows) extending from the cervix to the coccyx and to the sciatic foramen on the left side.
1477-7819-3-42-1.jpg
PMC1190221_01_1477-7819-3-42-1.jpg
F1
No involvement of the small bowel or bladder was detected (Figures 1, 2, 3).
T1- weighted fat saturated MR image after i.v. application of contrast medium coronal. The arrow is pointing to a fistulating formation spreading in the gluteal muscles on the left side with typical rim enhancement and central liquid components; the soft tissue mass seen in midline has a centrally necrotizing appearance.
1477-7819-3-42-2.jpg
PMC1190221_01_1477-7819-3-42-2.jpg
F2
No involvement of the small bowel or bladder was detected (Figures 1, 2, 3).
T1- weighted fat saturated MR image after i.v. application of contrast medium sagittal view. Presacrally, the mass characterized by an inhomogeneous contrast medium uptake in the thickened, nodular wall spreads in the subperiosteal space, as indicated.
1477-7819-3-42-3.jpg
PMC1190221_01_1477-7819-3-42-3.jpg
F3
No involvement of the small bowel or bladder was detected (Figures 1, 2, 3).
Histopathological overview of the fistula opening on the perineum consisting of mucus containing cystic spaces, partially lined by cylindrical epithelium of the mucinous adenocarcinoma. H&E, x 25.
1477-7819-3-42-4.jpg
PMC1190221_01_1477-7819-3-42-4.jpg
F4
Examination of the specimen showed typical cylindrical epithelium of colorectal type lining some residual lumina of fistulas and cysts (Figure 4).
Dermal infiltration of the mucinous adenocarcinoma undermining the perineal skin. PAS-stain, x 50.
1477-7819-3-42-5.jpg
PMC1190221_01_1477-7819-3-42-5.jpg
F5
But there were some minor residual carcinomatous infiltrates in the soft tissues between coccygeal bone and dorsal wall of the vagina (Figure 5).