case_images: PMC6332972_01
case_images: MRI showing the rectal lesion with the perirectal fat stranding.
case_images: CRIONM2018-9246139.001.jpg
case_images: PMC6332972_01_CRIONM2018-9246139.001.jpg
case_images: fig1
case_images: MRI showed a rectal mass with circumferential thickening and stranding extending to the pelvic side wall (Figure 1) with multiple large left iliac and mesorectal lymph nodes reaching a size of 2.8 cm. Multiple foci of T2 hyperintensity and enhancement were detected involving the lumbar and sacral spine, both iliac bones, and proximal femura.
case_images: Bone scan showing the widespread osseous deposits.
case_images: CRIONM2018-9246139.002.jpg
case_images: PMC6332972_01_CRIONM2018-9246139.002.jpg
case_images: fig2
case_images: Bone scan confirmed the widespread active osseous lesions involving the spine, ribs, and pelvic bones (Figure 2).
case_images: SPECT-CT showing diffuse bone and bone marrow lesions.
case_images: CRIONM2018-9246139.003.jpg
case_images: PMC6332972_01_CRIONM2018-9246139.003.jpg
case_images: fig3
case_images: SPECT-CT suggested diffuse bone infiltration (Figure 3).
case_images: Graph showing the hemoglobin (g/dl) and white cell count (K/ml) of the patient during the disease course.
case_images: CRIONM2018-9246139.004.jpg
case_images: PMC6332972_01_CRIONM2018-9246139.004.jpg
case_images: fig4
case_images: Between June 1 and 14, he received palliative radiotherapy to the pelvis in a dose of 30 grays over 10 fractions with improvement of the rectal bleeding and was scheduled to start palliative chemotherapy, but the patient became pale and developed progressive and prolonged drop in his hemoglobin and platelet levels (Figures 4 and 5).
case_images: Graph showing the platelet count (K/ml) of the patient during the disease course.
case_images: CRIONM2018-9246139.005.jpg
case_images: PMC6332972_01_CRIONM2018-9246139.005.jpg
case_images: fig5
case_images: Between June 1 and 14, he received palliative radiotherapy to the pelvis in a dose of 30 grays over 10 fractions with improvement of the rectal bleeding and was scheduled to start palliative chemotherapy, but the patient became pale and developed progressive and prolonged drop in his hemoglobin and platelet levels (Figures 4 and 5).
case_images: MRI showing leptomeningeal thickening.
case_images: CRIONM2018-9246139.006.jpg
case_images: PMC6332972_01_CRIONM2018-9246139.006.jpg
case_images: fig6
case_images: CT brain showed prominent bilateral hypodense collection more to the left with some linear opacities and diffuse cortical effacement (Figure 6).
case_images: MRI showing sphenoidal and ethmoidal mucosal thickening.
case_images: CRIONM2018-9246139.007.jpg
case_images: PMC6332972_01_CRIONM2018-9246139.007.jpg
case_images: fig7
case_images: MRI brain showed diffuse meningeal thickening and enhancement with evidence of sphenoidal and ethmoidal mucosal thickening (Figure 7).