PMC7243000_01
Sagittal and axial (B) reformatting for abdomen and pelvis CT scan show diffuse wall thickening of the colon with haziness of the meso-rectal fat planes and multiple regional enlarged lymph nodes. The thickening is extending into the anus. There are also multiple enlarged lymph nodes in inguinal areas.
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Tomography (CT) scan of the abdomen and pelvis (Fig. 1, Fig. 2, Fig. 3) demonstrated a circumferential enhancing wall thickening involving the whole rectum with ill-defined hypodense area seen 7-9 o'clock with possible involvement of the anal canal associated with diffuse edema and fat stranding of the mesorectum.
CT scan upper abdomen with IV contrast shows no abdominal organs metastases.
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Tomography (CT) scan of the abdomen and pelvis (Fig. 1, Fig. 2, Fig. 3) demonstrated a circumferential enhancing wall thickening involving the whole rectum with ill-defined hypodense area seen 7-9 o'clock with possible involvement of the anal canal associated with diffuse edema and fat stranding of the mesorectum.
CT scan of the chest with IV contrast shows bilateral hilar and mediastinal enlarged lymph nodes.
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CT Chest (Fig. 4) demonstrated multiple bilateral tiny pulmonary nodules, the largest one measuring 4 mm in the right upper lobe.
a) The tumor involved the dermis and subcutaneous tissue [hematoxylin-eosin (H&E), original magnification x40]. b) The tumor consisted of complex and single neoplastic glandular structures with intervening desmoplastic stroma [H&E, original magnification x100]. c) Immunohistochemical staining for CDX2 shows diffuse and strong nuclear staining in the neoplastic cells [original magnification x100].
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Histopathological exam of rectal biopsies revealed moderately differentiated rectal adenocarcinoma, while the skin of the right inguinal area showed metastatic cutaneous rectal adenocarcinoma (Fig. 5a, b, c).