PMC8039191_01
(A) Histopathologic photo with 20x magnification showing malignant cells floating in mucin. (B) Histopathologic photo with 4x magnification showing extravasated mucin with histiocytic reaction.
IMCRJ-14-223-g0001.jpg
PMC8039191_01_IMCRJ-14-223-g0001.jpg
f0001
The mucin had extravasated to the surrounding tissue and elicited a histiocytic reaction (Figure 1).
Axial cut of a computed tomography scan of the pelvis showing a left inguinal lymph node (white arrow).
IMCRJ-14-223-g0002.jpg
PMC8039191_01_IMCRJ-14-223-g0002.jpg
f0002
The CT of the abdomen revealed an ill-defined, solid mass at the right adnexa measuring 3.2 cm that could represent ovarian metastases or a metastatic lymph node; an inguinal lymph node measuring 1.6 cm was also noted on the left side (Figure 2).
Axial cut of a computed tomography scan of the pelvis at recurrence showing thickened sacral area (Black dot).
IMCRJ-14-223-g0003.jpg
PMC8039191_01_IMCRJ-14-223-g0003.jpg
f0003
A CT-guided biopsy of the thickened sacral area was also obtained and revealed adenocarcinoma (Figure 3).
Speculated, intense, enhancing, soft-tissue mass at the surgical bed on MRI (sagittal, T1 with contrast).
IMCRJ-14-223-g0004.jpg
PMC8039191_01_IMCRJ-14-223-g0004.jpg
f0004
It measured 9 cmx5.3 cm (Figure 4).
Radiotherapy dose distribution with high dose areas in green.
IMCRJ-14-223-g0005.jpg
PMC8039191_01_IMCRJ-14-223-g0005.jpg
f0005
She received a dose of 45 Gy in 28 fractions to the entire pelvis and inguinal area, with concomitant 58.8 Gy delivered to the sacral mass and the enlarged inguinal lymph node (Figure 5).
Changes in levels of CEA and CA 19-9 over the clinical course.
IMCRJ-14-223-g0006.jpg
PMC8039191_01_IMCRJ-14-223-g0006.jpg
f0006
Figure 6 reflects the change in her CEA level over the clinical course.