case_images: PMC11330332_01
case_images: Small bowel cancer findings. (a) Contrast-enhanced computed tomography of the abdomen showing neoplastic lesions in the small bowel. (b) Capsule endoscopy showing a Type 2 tumor, 2 cm in diameter. (c) Surgical specimen showing a Type 2 tumor measuring 25 x 10 mm. (d) Histopathology showing columnar cell growth forming fused, cribriform, and papillary ducts, characteristic of moderately differentiated adenocarcinoma (hematoxylin and eosin stain; space bar: 100 mum).
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case_images: fig1
case_images: Type 2 tumor measuring 25 x 10 mm with high columnar cell growth forming fused, cribriform, and papillary ducts on histopathology. The tumor was diagnosed as a moderately differentiated adenocarcinoma, pT4, pN2, cM0, and Stage IIIB (Figure 1).
case_images: Findings of the tumor in the ovary 5 months after small bowel cancer surgery. (a) T2-weighted magnetic resonance imaging (MRI) showing left ovarian enlargement. (b) Surgical specimen of the left ovary. The left ovary showed a grayish-white to yellowish-white, substantial lesion with cyst formation. (c) Histopathology of the left ovary showing findings similar to the small bowel cancer (hematoxylin and eosin stain; space bar: 100 mum).
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case_images: A magnetic resonance imaging (MRI) scan revealed a left ovarian tumor with heterogenous enhancement, measuring 107 x 57 mm (Figure 2). A bilateral abdominal adnexectomy was performed, and histopathological examination revealed the same histopathology as the previous small bowel cancer (Figure 2).
case_images: Imaging showing a tumor in the uterus 24 months after small bowel cancer surgery. (a) Contrast-enhanced computed tomography (CT) showing uterine enlargement. (b) Positron emission tomography (PET)/CT showing accumulation in the uterus.
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case_images: A positron emission tomography (PET)/CT scan 24 months after the small bowel cancer surgery revealed accumulation in the uterus and obturator lymph nodes (Figure 3), and the patient was referred back to our department with suspected uterine metastasis of the small bowel cancer.
case_images: Endometrial findings of the tumor in the uterus. (a) Endometrial cytology showing clusters of atypical cells with enlarged nuclei, irregular karyotype, and distinct nuclei on a hematogenous background; prominence of irregular stacking and disarrangement of nuclei, consistent with adenocarcinoma (space bar: 50 mum). (b) Endometrial histology showing atypical cells proliferating solidly within the stromal tissue, suggesting poorly differentiated carcinoma (hematoxylin and eosin stain; space bar: 200 mum).
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case_images: Endometrial histology revealed atypical cells proliferating solidly within the stromal tissue, a finding that suggested poorly differentiated carcinoma (Figure 4).
case_images: Characteristics of the uterine tumor. (a) Left, uterus; middle and right, histopathology showing moderate to poorly differentiated adenocarcinoma spreading extensively throughout the uterus with lymphatic invasion (hematoxylin and eosin stain; space bar: 200 mum). (b) (left to right) immunostaining for CK7 (-), CK20 (+), SATB2 (+), PAX2 (-), and ER (-). These results are typical of gastrointestinal cancer rather than uterine cancer (Table 1) and led to the diagnosis of uterine metastasis of small bowel cancer rather than primary uterine cancer. CK7, Cytokeratin 7; CK20, Cytokeratin 20; ER, estrogen receptor; PAX2, Paired Box Gene 2; SATB2, Special AT-Rich Sequence-Binding Protein 2.
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