case_images: PMC7204777_01
case_images: PMC7204777_02
case_images: Contrast-enhanced computed tomography. A-E July 2014. Pathological malignant lesion in the left adrenal gland. Contrast agents are not stored homogenously, suggesting the presence of necrotic zones. Enlarged lymph node in the mesentery and small lesions in the peritoneum were observed. F-J September 2014. The malignant lesion in the left adrenal gland has increased in size with larger necrotic zones and new subcutaneous pathological lesions. K-O February 2015. Enlarged lymph node in the axillary region, pathological lesion in the right adrenal gland, lesions in the mesenteric adipose tissue and subcutaneously as well as lesion in the left gluteal muscle were observed. P-T December 2015. Positive changes were observed; lymph node in the left axillary region has decreased in size, but lesions in the mesenteric adipose tissue and subcutaneously as well as lesion in the left gluteal muscle were still observed. U-X September 2016. Subcutaneous lesion was not observed, however, lesions in the left gluteal muscle and lesion with calcified inclusions in the right adrenal gland was observed. A new lesion laterally from the ascending colon was observed. Y, Z August 2017. No change in the radiological findings, except the lesion laterally from the ascending colon that has increased in size. AA, AB June 2018. Lesion in the left gluteal muscle and lesion laterally from the ascending colon has increased in size. AC-AE June 2019. Lesions in both gluteal regions and the right ileocecal region were observed. Lesion in the left gluteal region has increased in size by 0.3 cm.
case_images: cro-0013-0424-g01.jpg
case_images: PMC7204777_06_cro-0013-0424-g01.jpg
case_images: F1
case_images: After 11 months, positive changes were observed; the lymph node in the left axillary region has decreased in size, while lesions in the mesenteric adipose tissue and subcutaneously and the lesion in the left gluteal muscle were still observed (Fig. 1P-T). A new lesion laterally from the ascending colon was observed (Fig. 1U-X). In August 2017, no change in the radiological findings was observed, except the lesion laterally from the ascending colon that had increased in size (Fig. 1Y-Z). In June 2018, the lesion in the left gluteal muscle and the lesion laterally from the ascending colon had increased in size (Fig. 1AA-AB).
case_images: Representative photomicrograph demonstrated epitheliod and nevoid pigmented melanoma metastatic to the periadrenal tissue lymph node. Magnification x40 (A). Nevoid and epitheliod melanoma in the adrenal gland. Magnification x40 (B); magnification x100 (C).
case_images: cro-0013-0424-g02.jpg
case_images: PMC7204777_02_cro-0013-0424-g02.jpg
case_images: F2
case_images: Eight metastatic lymph nodes were revealed (Fig. 2A-C). The mitotic activity was up to 5 mitotic figures/mm2.
case_images: Representative photomicrographs demonstrated epitheliod and nevoid weakly pigmented melanoma in the gastric submucosa and muscle layer tissue. Magnification x40 (A); magnification x100 (B); magnification x200 (C). Immunohistochemical staining demonstrated Melan A expression in the tumor, magnification x100 (D), scale bar = 100 mum.
case_images: cro-0013-0424-g03.jpg
case_images: PMC7204777_02_cro-0013-0424-g03.jpg
case_images: F3
case_images: The tumor was located in the submucosa and muscle layers with lymphovascular invasion (Fig. 3A-D).
case_images: PMC7204777_03
case_images: PMC7204777_04
case_images: PMC7204777_05
case_images: Contrast-enhanced computed tomography. A-E July 2014. Pathological malignant lesion in the left adrenal gland. Contrast agents are not stored homogenously, suggesting the presence of necrotic zones. Enlarged lymph node in the mesentery and small lesions in the peritoneum were observed. F-J September 2014. The malignant lesion in the left adrenal gland has increased in size with larger necrotic zones and new subcutaneous pathological lesions. K-O February 2015. Enlarged lymph node in the axillary region, pathological lesion in the right adrenal gland, lesions in the mesenteric adipose tissue and subcutaneously as well as lesion in the left gluteal muscle were observed. P-T December 2015. Positive changes were observed; lymph node in the left axillary region has decreased in size, but lesions in the mesenteric adipose tissue and subcutaneously as well as lesion in the left gluteal muscle were still observed. U-X September 2016. Subcutaneous lesion was not observed, however, lesions in the left gluteal muscle and lesion with calcified inclusions in the right adrenal gland was observed. A new lesion laterally from the ascending colon was observed. Y, Z August 2017. No change in the radiological findings, except the lesion laterally from the ascending colon that has increased in size. AA, AB June 2018. Lesion in the left gluteal muscle and lesion laterally from the ascending colon has increased in size. AC-AE June 2019. Lesions in both gluteal regions and the right ileocecal region were observed. Lesion in the left gluteal region has increased in size by 0.3 cm.
case_images: cro-0013-0424-g01.jpg
case_images: PMC7204777_06_cro-0013-0424-g01.jpg
case_images: F1
case_images: After 11 months, positive changes were observed; the lymph node in the left axillary region has decreased in size, while lesions in the mesenteric adipose tissue and subcutaneously and the lesion in the left gluteal muscle were still observed (Fig. 1P-T). A new lesion laterally from the ascending colon was observed (Fig. 1U-X). In August 2017, no change in the radiological findings was observed, except the lesion laterally from the ascending colon that had increased in size (Fig. 1Y-Z). In June 2018, the lesion in the left gluteal muscle and the lesion laterally from the ascending colon had increased in size (Fig. 1AA-AB).
case_images: PMC7204777_06
case_images: Contrast-enhanced computed tomography. A-E July 2014. Pathological malignant lesion in the left adrenal gland. Contrast agents are not stored homogenously, suggesting the presence of necrotic zones. Enlarged lymph node in the mesentery and small lesions in the peritoneum were observed. F-J September 2014. The malignant lesion in the left adrenal gland has increased in size with larger necrotic zones and new subcutaneous pathological lesions. K-O February 2015. Enlarged lymph node in the axillary region, pathological lesion in the right adrenal gland, lesions in the mesenteric adipose tissue and subcutaneously as well as lesion in the left gluteal muscle were observed. P-T December 2015. Positive changes were observed; lymph node in the left axillary region has decreased in size, but lesions in the mesenteric adipose tissue and subcutaneously as well as lesion in the left gluteal muscle were still observed. U-X September 2016. Subcutaneous lesion was not observed, however, lesions in the left gluteal muscle and lesion with calcified inclusions in the right adrenal gland was observed. A new lesion laterally from the ascending colon was observed. Y, Z August 2017. No change in the radiological findings, except the lesion laterally from the ascending colon that has increased in size. AA, AB June 2018. Lesion in the left gluteal muscle and lesion laterally from the ascending colon has increased in size. AC-AE June 2019. Lesions in both gluteal regions and the right ileocecal region were observed. Lesion in the left gluteal region has increased in size by 0.3 cm.
case_images: cro-0013-0424-g01.jpg
case_images: PMC7204777_06_cro-0013-0424-g01.jpg
case_images: F1
case_images: After 11 months, positive changes were observed; the lymph node in the left axillary region has decreased in size, while lesions in the mesenteric adipose tissue and subcutaneously and the lesion in the left gluteal muscle were still observed (Fig. 1P-T). A new lesion laterally from the ascending colon was observed (Fig. 1U-X). In August 2017, no change in the radiological findings was observed, except the lesion laterally from the ascending colon that had increased in size (Fig. 1Y-Z). In June 2018, the lesion in the left gluteal muscle and the lesion laterally from the ascending colon had increased in size (Fig. 1AA-AB).