PMC6796696_01
CT images before (A, B) and after (C, D) chemotherapy. A 7.0 x 6.0 cm solid tumor apparently located in the left lobe of liver (A, C) and luminal narrowing with marked wall thickening involving the ascending colon (B, D) are seen. The colon lesion has become smaller with chemotherapy but the size of the liver lesion has not changed significantly.
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Computed tomography (CT) revealed a 7.0 x 6.0 cm solid tumor apparently located in the left lobe of the liver (Fig. 1a) and luminal narrowing and marked wall thickening involving the ascending colon (Fig. 1B). A repeat CT revealed reduction in size of the colonic lesion but no significant change in the liver lesion (Fig. 1C, D) compared with the CT findings before chemotherapy (Fig. 1 A, B).
Preoperative MRI and FDG PET/CT scan findings. (A) T1-weighted MRI image showing low intensity. (B) T2-weighted MRI image showing heterogeneous high intensity. (C, D) FDG PET/CT scan image showing increased tracer accumulation in both the colon (SUVmax = 5.66) and liver (SUVmax = 5.37) lesions.
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Magnetic resonance imaging (MRI) revealed low intensity on T1-weighted images (Fig. 2A) and heterogeneously high intensity on T2-weighted images (Fig. 2B). Whole body positron emission tomography-computed tomography (PET/CT) imaging showed increased tracer accumulation in both the colon (maximum standard uptake value [SUVmax] = 5.66) (Fig. 2B C) and liver (SUVmax = 5.37) (Fig. 2D) lesions.
Pathological findings of the liver lesion. (A) Macroscopically the 7.0 x 6.0 cm tumor is solitary, yellowish, encapsulated, and has a smooth surface. (B) Microscopically, there are proliferating spindle-like tumor cells arranged in a fascicular fashion (C) Immunohistochemically, the tumor cells ae positive for S-100 protein. (D) The Ki-67 index is about 3%.
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Macroscopically, the liver specimen contained a solitary, yellowish encapsulated 7.0 x 6.0 cm tumor with a smooth surface that was adjacent to rather than within the liver (Fig. 3A). On microscopic examination, proliferating spindle-like tumor cells arranged in a fascicular fashion and accompanied by collagenous fibers were observed (Fig. 3B). Immunohistochemically, the tumor cells were strongly positive for S-100 protein (Fig. 3C) and the Ki67-index was about 3% (Fig. 3D).