case_images: PMC10764574_01
case_images: Preoperative CT images of this patient. (A) Coronal section CT showed blurred boundaries between the descending colon mass and the adjacent peritoneum and abdominal wall, as well as blurred periintestinal fat spaces (yellow arrow); (B) Transverse plane CT revealed irregular thickening of the intestinal wall of the descending colon (yellow arrow), forming soft tissue masses approximately 9.9*8.5*10.4 cm.
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case_images: Abdominal computed tomography (CT) indicated a high possibility of descending colon cancer involving the surrounding fat space, adjacent peritoneum, and abdominal wall, with potential peri-intestinal and para-aortic lymph node metastasis ( Figures 1A, B ). The cells were small round cells with sparse cytoplasm, round and deeply stained nuclei, unclear nucleoli, and mitotic figures of approximately 26 per 1.732 square millimeters ( Figure 3C ).
case_images: Colonoscopy and pathological results of biopsy. (A) The tumor of the descending colon surrounded the whole intestinal cavity, the intestinal cavity was narrow, the surface of the tumor was rough and uneven, and the mucosa was eroded; (B) The descending colon mass was easily bled when touched; (C) (H&E) The malignant tumor with significant necrosis and interstitial mucinous degeneration; (D) (H&E) The tumor cells were small round with sparse cytoplasm, round nuclei and obscure nucleoli, suggesting small round cell undifferentiated sarcoma.
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case_images: Additionally, the tumor appeared to be attached to the surrounding tissues ( Figures 2A, B ). The pathological results suggested that the descending colon was a small round cell undifferentiated sarcoma with interstitial mucinous degeneration ( Figures 2C, D ).
case_images: Intraoperative image of this patient and pathological examination results. (A) The mass was of the giant type, with a size of 15*13*9 cm. Most of the mass was raised on the serous surface of the intestinal duct, involving the whole intestinal wall to the surrounding fat, with obvious necro-sis and a small amount of bleeding. (B) (H&E) The tumor cells were ethmoid and glandular tubes floating in the mucous pool, suggesting mucinous adenocarcinoma. (C) (H&E) The tumor cells were diffusely arranged with sparse cytoplasm, round nuclei deeply stained, and obscure nucleoli, and the fission was approximately 26/1.732 square millimeters, suggesting small round cell undifferentiated sarcoma.
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case_images: The tumor had a size of approximately 16 cm * 11 cm * 18 cm ( Figure 3A ). Microscopic examination of the tumor revealed that it was composed of two distinct components ( Figure 3B ): the tumor cells were deposited in a cribriform and tubular shape floating in the mucus pool, and another kind of tumor cell was diffusely arranged in sheets. The cells were small round cells with sparse cytoplasm, round and deeply stained nuclei, unclear nucleoli, and mitotic figures of approximately 26 per 1.732 square millimeters ( Figure 3C ).