case_images: PMC7243000_01
case_images: Sagittal and axial (B) reformatting for abdomen and pelvis CT scan show diffuse wall thickening of the colon with haziness of the meso-rectal fat planes and multiple regional enlarged lymph nodes. The thickening is extending into the anus. There are also multiple enlarged lymph nodes in inguinal areas.
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case_images: Tomography (CT) scan of the abdomen and pelvis (Fig. 1, Fig. 2, Fig. 3) demonstrated a circumferential enhancing wall thickening involving the whole rectum with ill-defined hypodense area seen 7-9 o'clock with possible involvement of the anal canal associated with diffuse edema and fat stranding of the mesorectum.
case_images: CT scan upper abdomen with IV contrast shows no abdominal organs metastases.
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case_images: fig0015
case_images: Tomography (CT) scan of the abdomen and pelvis (Fig. 1, Fig. 2, Fig. 3) demonstrated a circumferential enhancing wall thickening involving the whole rectum with ill-defined hypodense area seen 7-9 o'clock with possible involvement of the anal canal associated with diffuse edema and fat stranding of the mesorectum.
case_images: CT scan of the chest with IV contrast shows bilateral hilar and mediastinal enlarged lymph nodes.
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case_images: CT Chest (Fig. 4) demonstrated multiple bilateral tiny pulmonary nodules, the largest one measuring 4 mm in the right upper lobe.
case_images: a) The tumor involved the dermis and subcutaneous tissue [hematoxylin-eosin (H&E), original magnification x40]. b) The tumor consisted of complex and single neoplastic glandular structures with intervening desmoplastic stroma [H&E, original magnification x100]. c) Immunohistochemical staining for CDX2 shows diffuse and strong nuclear staining in the neoplastic cells [original magnification x100].
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case_images: Histopathological exam of rectal biopsies revealed moderately differentiated rectal adenocarcinoma, while the skin of the right inguinal area showed metastatic cutaneous rectal adenocarcinoma (Fig. 5a, b, c).