case_images: PMC10884171_01
case_images: Computed tomography enhanced scan. (A) Normal pancreas. (B) Uterine adnexal mass and pelvic metastatic lesion, right: sagittal view. (C) Thickening of the junction area between the rectum and the sigmoid colon and multiple pelvic nodules. (D) Multiple nodules in the abdominal cavity. (E) Venous phase, a nodule in the right lobe of the liver.
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case_images: CT scans of the abdomen and pelvis ( Figure 1 ) showed no pancreatic exudation, multiple hyperintense nodules in the abdominopelvic cavity and greater omental peritoneum, patchy dense shadows in the adnexal region of the pelvis, poorly displayed uterine region, thickened wall of the junction between the sigmoid colon and the rectum, and a nodule in the right lobe of the liver.
case_images: Positron emission tomography. (A) Rectouterine pouch and uterine adnexal mass. (B-D) Multiple nodular shadows in the abdominopelvic cavity and greater omentum, inhomogeneous thickening of the local peritoneum adjacent to the left colon. (E, F) Hypodense shadow in the right lobe of the liver with increased FDG metabolism; foci of increased FDG metabolism in the caudate lobe of the liver and spleen.
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case_images: Tomography (PET) which revealed invasions of the abdominal wall and intestinal wall ( Figure 2 ).
case_images: Pathological diagnosis. (A) From left to right: H&E staining results (x100) of needle biopsy of abdominal wall mass, endoscopic biopsy specimen, and surgical resection of ovarian tissue. The tumor cells are oval-shaped, varying in size, with large, deeply stained nuclei, prominent cell atypia, and easily observable mitotic figures. (B) Immunohistochemical staining results of ovarian tissue (x100). Consistent with the features of HGSOC according to the WHO classification: diffuse nuclear expression of WT1, mutant p53 expression, positive staining for CA125 and PAX8, and frequent ER expression. Negative staining for common immunohistochemical markers of colorectal cancer, such as Villin and CDX-2 proteins.
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case_images: The patient then underwent percutaneous biopsy of the abdominal wall mass and endoscopic biopsy to obtain tissue samples for immunohistochemical staining. The histological examination of the percutaneous biopsy of the abdominal wall mass showed poorly differentiated carcinoma, suggesting a possible adnexal origin ( Figure 3A ). Further endoscopic biopsy was performed, and the histological examination revealed poorly differentiated carcinoma, suggesting a possible adnexal origin ( Figure 3A ). Figure 3B ). Following surgery, the patient had the original chemotherapy therapy schedule for two cycles.