PMC8077599_01
The tumor is 4 cm in size with a perforation of 2 mm. The arrow indicates the perforated area (a). H&E staining shows that the tumor is characterized by spindle-shaped cells in disarray with invasive growth (b). Immunohistochemical findings show that tumor cells are broadly positive for cytokeratin-AE1/AE3 (c), and that the Ki-67 labeling index is about 50% in the hot spot (d).
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F1
Pathological examination revealed the tumor with a maximum diameter of 4 cm in the small intestine, and the tumor had invaded from the mucosa into the serosa with perforation (Fig. 1a). Histologically, the tumor was characterized by complicated and invasive growth of atypical spindle-shaped cells (Fig. 1b). Immunohistochemically, the tumor cells were broadly positive for cytokeratin-AE1/AE3 (Fig. 1c) and partially positive for alpha-smooth muscle actin and S-100 protein. The Ki-67 labeling index was approximately 50% in the hot spot (Fig. 1d).
PET-CT scan at 7 months postoperatively shows lymph node metastasis with an SUVmax of 7.2 in front of the inferior vena cava (a; arrow) and recurrence with an SUVmax of 8.3 in the abdominal cavity of the right lower abdomen (b; arrow). Seven months after the recurrence had been identified, the CT scan shows that ascites appeared (c; arrows), as well as rapid growth of metastatic lymph nodes and the recurrent tumor (c, d; arrows).
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F2
Seven months after the operation, a positron emission tomography (PET)-CT scan showed lymphadenopathy with a maximum standardized uptake value (SUVmax) of 7.2 anterior to the inferior vena cava (Fig. 2a) and a tumor with an SUVmax of 8.3 in the abdominal cavity of the right lower abdomen (Fig. 2b). The lymph node metastasis had gradually progressed and ascites appeared on CT (Fig. 2c); in addition, the recurrent tumor in the abdominal cavity had rapidly grown to 13 cm in diameter on the CT scan 7 months after PET-CT imaging (Fig. 2d).