case_images: PMC11176451_01
case_images: (A) Contrast-enhanced computerized tomography (CECT) of the left ureteral segment and left hydronephrosis. CECT revealed a 20-mm lesion on the left ureteral segment. Neuroendocrine carcinoma and adenocarcinoma in biopsy. Low ((B), hematoxylin-eosin, x 40) and intermediate [(C), hematoxylin-eosin, x 200] magnification showing adenocarcinoma and Neuroendocrine carcinoma. Neuroendocrine in biopsy: High magnification [(D), hematoxylin-eosin, x 400]. Adenocarcinoma in biopsy: High magnification [(E), hematoxylin-eosin, x 400].
case_images: fonc-14-1390350-g001.jpg
case_images: PMC11176451_01_fonc-14-1390350-g001.jpg
case_images: f1
case_images: Computed tomography (CT) revealed a 25-mm extensive heterogeneously-enhanced mass in the middle and lower part of his left ureteral segment and left hydronephrosis ( Figure 1A ). Microscopically, the tumor protruding into the lumen comprised two intimately admixed morphological tumor cells ( Figures 1B, C ). Most cells (55%) exhibited solid and trabecular growth, were small, and had round or spindle-shapes, scant cytoplasm, dark staining, inconspicuous nucleoli, extensive necrosis, and a mitotic index of 60/10 high-power fields (HPFs) ( Figures 1D ). The other 45% of tumor cells exhibited glandular lumens and papillary formation, with larger tumor cells, columnar and cubic, abundant cytoplasm, conspicuous nucleoli, enteric and mucinous differentiation, and a mitotic index of 4/10 HPFs ( Figures 1E ).
case_images: Neuroendocrine carcinoma and adenocarcinoma in biopsy. Low [(A), hematoxylin-eosin, x 40]. Immunohistochemical staining showed positivity for a urothelial marker [(GATA3 (B)], neuroendocrine marker [synaptophysin (C)], adenocarcinoma marker [CDX2 (D)], a neuroendocrine marker [CD56 (E)], adenocarcinoma marker [CDX2 (F), epithelial marker (CKpan (G)], a neuroendocrine marker [INSM1 (H)], a neuroendocrine marker [SSTR2 (I)] and proliferation index marker [Ki67 (J)].
case_images: fonc-14-1390350-g002.jpg
case_images: PMC11176451_01_fonc-14-1390350-g002.jpg
case_images: f2
case_images: Immunohistochemistry showed positive staining in different histological components ( Figures 2A-J ).