case_images: PMC11162220_01
case_images: There were more adulterants in the thyroid gland, with disordered arrangement, some glands fused, and obvious cell atypia. The arrow indicates the heterocyst.
case_images: CMAR-16-575-g0001.jpg
case_images: PMC11162220_01_CMAR-16-575-g0001.jpg
case_images: f0001
case_images: The thyroid adenocarcinoma was shown by a histological analysis of the specimen (Figure 1).
case_images: Immunohistochemistry revealed adenoid arrangement of heteromorphic cells with interstitial fibrosis. Immunohistochemistry revealed positive expression of CDX-2 (an intestinal specific transcription factor) and Villin, while negative expression of TG (thyroglobulin), suggesting a high possibility of intestinal metastatic adenocarcinoma. (A) The tumor cells (blue arrows) are adenoid and distributed in the thyroid tissue. And the thyroid follicles can be seen (red arrows); (B) The tumor cells were positive for CDX-2; (C) The tumor cells Villin were positive; (D) TG in thyroid follicles was positive and TG in tumor cells was negative.
case_images: CMAR-16-575-g0002.jpg
case_images: PMC11162220_01_CMAR-16-575-g0002.jpg
case_images: f0002
case_images: Positive CDX2 and cytokeratin 20, and negative thyroid transcription factor 1 (TTF1) and thyroglobulin (TG) (Figure 2) were revealed by immunohistochemistry examinations, which indicated that the primary tumor originated was from the gastrointestinal tract.
case_images: Heterotypic glands fused, partially ethmoidal, with marked interstitial fibrosis. The arrow indicates Cribriform heteromorphic cell fusion.
case_images: CMAR-16-575-g0003.jpg
case_images: PMC11162220_01_CMAR-16-575-g0003.jpg
case_images: f0003
case_images: Histological analysis of the specimen confirmed moderately differentiated adenocarcinoma (Figure 3).
case_images: The 18F-FDG PET/CT scan images showing increased focal FDG uptake in the rectal mass and pelvic lymph nodes.
case_images: CMAR-16-575-g0004.jpg
case_images: PMC11162220_01_CMAR-16-575-g0004.jpg
case_images: f0004
case_images: Positron Emission Tomography-Computed Tomography (PET-CT) showed colorectal carcinoma accompanied by multiple lymph nodes metastases (Figure 4).
case_images: The FDG metabolism of multiple omentum nodules and pelvic peritoneal nodules which have unclear boundary with the anterior wall of rectum was increased.
case_images: CMAR-16-575-g0005.jpg
case_images: PMC11162220_01_CMAR-16-575-g0005.jpg
case_images: f0005
case_images: Then, on October 18, 2021, a second PET-CT examination suggested multiple metastases of the abdominal omentum and pelvic cavity (Figure 5).