case_images: PMC11294831_01
case_images: CTA of the abdominal aorta at patient admission. (A, B, F) show artery-phase images. (C, D, E) are venous-phase images. The black arrow points to the tumor; the red triangle points to the inferior vena cava (the boundary between the inferior vena cava and the tumor is unclear); the blue arrow suggests renal pelvis expansion changes. The yellow arrow points to the liver metastasis.
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case_images: f1
case_images: Multiple abnormal enhancing lesions in the liver, considering metastases ( Figure 1 , three-dimensional reconstructions have been attached to the  Supplementary Material ).
case_images: High-resolution CT of the patient on admission (pulmonary window); the patient's lungs are seen to have multiple pulmonary metastases on admission. The red triangle points to the met. (A-D) shows high-resolution CT (lung window) images of different levels of the patient's lungs at the time of admission, where multiple pulmonary metastases were visible. Red triangles point to the metastases.
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case_images: High-resolution CT suggests multiple enhancing nodules in both lungs, considering multiple metastases in both lungs ( Figure 2 ).
case_images: FS-T2WI image of the patient's abdominal MRI on admission; the yellow arrow points to the location of the abdominal tumor; the blue arrow points to the liver metastases; the red arrow points to the lung metastases; the purple arrow points to the location of the inferior vena cava; (A) Tumor with multiple liver and lung metastases. (B) the tumor is seen encircling the inferior vena cava and is poorly demarcated from the inferior vena cava. (C) Tumor is in the form of an irregular lump, with internal heterogeneous enhancement and blurred margins. (D) the right renal pelvis is seen in the yellow box and is tortuously dilated and poorly demarcated from the tumor.
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case_images: Magnetic Resonance Imaging (MRI) suggests 1. a malignant lesion in the right abdominal cavity with liver and multiple metastases in both lungs, 2. right ureter compression, right renal obstructive hydronephrosis, and multiple lymph nodes enlargement around the lesion ( Figure 3 ).
case_images: Lung biopsy 20x light microscope image. (A, B) respectively shows 20x light microscope images of two lung biopsy tissues.
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case_images: The pathology revealed a large area of hemorrhagic necrosis and normal lung tissue structure, with a few clusters of atypical cells, combined with immunohistochemical findings to diagnose metastatic carcinoma ( Figures 4A, B ).
case_images: Retroperitoneal tumor pathology 40x light microscope image. (A, B) respectively shows 40x light microscope images of retroperitoneal tumor pathology at different locations.
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case_images: Immunohistochemistry: Pan-cytokeratin, CK7, CK19 (+), CD10 (+/-), HepPar1, TTF1, CD34, Syn, Gly-3, EMA, Villin, PLAP, CD30, AFP, OCT4, CD117 (-), GS (glutamine synthetase) focal slight (+), beta-HCG (+), SALL4 focally (+), KI-67: 80% ( Figures 5A, B ).
case_images: Ultrasound image of the testis. (A, B) Ultrasound image of the left testis; (C, D) Ultrasound image of the right testis.
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case_images: Several solid nodules were seen within the parenchyma ( Figures 6A-D ).
case_images: CT images of the chest and abdomen on the 6th postoperative day. (A, B) are CTs of the chest (pulmonary window); (C, D) are CTs of the abdomen; red arrows point to metastases in the lungs (significantly more extensive and numerous than before surgery). Blue arrows point to liver metastases (hypointense shadow significantly larger than before surgery).
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case_images: f7
case_images: The 6th postoperative CT of the chest and abdomen showed rapid progression of liver and lung metastases ( Figure 7 ).