PMC4887623_01
Ultrasonography.
CRIONM2016-7149821.001.jpg
PMC4887623_01_CRIONM2016-7149821.001.jpg
fig1
Abdominopelvic ultrasound showed bilateral complex adnexal masses (Figure 1) as well as moderate ascites.
CT scan (abdomen and pelvis).
CRIONM2016-7149821.002.jpg
PMC4887623_01_CRIONM2016-7149821.002.jpg
fig2
CT scan done showed two heterogeneously enhancing solid cystic lesions arising from the adnexae on either side measuring 12 x 9 cm on left and 9.7 x 8.5 cm on right, eccentric asymmetric wall thickening along the right posterolateral wall in the anal canal and rectum for a length of approximately 3-4 cm of maximal thickness 1.3 cm, and multiple hepatic metastatic lesions noted (Figure 2).
Sigmoidoscopy.
CRIONM2016-7149821.003.jpg
PMC4887623_01_CRIONM2016-7149821.003.jpg
fig3
Sigmoidoscopy (Figure 3) showed ulceroproliferative growth 1 cm from anal verge from which multiple biopsies were taken.
Photomicrograph showing neuroendocrine carcinoma involving the rectum.
CRIONM2016-7149821.004.jpg
PMC4887623_01_CRIONM2016-7149821.004.jpg
fig4
Rectal and ovarian biopsies were consistent with neuroendocrine carcinoma (Figures 4 and 5).
Photomicrograph showing tumor composed of cells with round to oval nuclei and stippled chromatin.
CRIONM2016-7149821.005.jpg
PMC4887623_01_CRIONM2016-7149821.005.jpg
fig5
Rectal and ovarian biopsies were consistent with neuroendocrine carcinoma (Figures 4 and 5).
Tumor cells showing positivity for synaptophysin (immunohistochemistry for synaptophysin, x200).
CRIONM2016-7149821.006.jpg
PMC4887623_01_CRIONM2016-7149821.006.jpg
fig6
Immunocytochemistry for synaptophysin and chromogranin was positive (Figures 6 and 7) and also immunolabelled as Ki67 antigen positive.
Tumor cells showing positivity for chromogranin (immunohistochemistry for chromogranin, x200).
CRIONM2016-7149821.007.jpg
PMC4887623_01_CRIONM2016-7149821.007.jpg
fig7
Immunocytochemistry for synaptophysin and chromogranin was positive (Figures 6 and 7) and also immunolabelled as Ki67 antigen positive.