case_images: PMC10882214_01
case_images: Abdominal CT images at diagnosis.. Abdominal CT (a, b, c) shows the pronounced thickening of the bowel wall in the ascending colon (indicated by the arrow).
case_images: cureus-0016-00000052765-i01.jpg
case_images: PMC10882214_01_cureus-0016-00000052765-i01.jpg
case_images: FIG1
case_images: Presently, an abdominal computed tomography (CT) scan showed a thickening of the bowel wall in the ascending colon (Figure 1).
case_images: Colonoscopy image at diagnosis.. Colonoscopy illustrating edematous folds and mild stenosis of the ascending (a, b) and sigmoid colon (c).
case_images: cureus-0016-00000052765-i02.jpg
case_images: PMC10882214_01_cureus-0016-00000052765-i02.jpg
case_images: FIG2
case_images: Colonoscopy findings indicated the presence of edematous folds and mild stenosis of the ascending and sigmoid colon (Figure 2).
case_images: Upper endoscopy image at diagnosis.. Upper endoscopy reveals discolored and depressed lesions in the anterior wall of the fornix (a) and the angulus (b) (indicated by the arrow). Magnifying blue laser imaging reveals an irregular surface pattern with irregular microvasculature in the depressed area of the angulus (c).
case_images: cureus-0016-00000052765-i03.jpg
case_images: PMC10882214_01_cureus-0016-00000052765-i03.jpg
case_images: FIG3
case_images: Additionally, upper GI endoscopy revealed multiple discolored and depressed lesions in the stomach (Figure 3).
case_images: Histological examinations of the ascending colon specimen.. Hematoxylin and eosin staining demonstrates the presence of poorly differentiated adenocarcinoma with signet ring cell within the mucosal tissue (a). Immunohistochemistry results reveal positive staining for cytokeratin 7 (b), estrogen receptor (c), and gross cystic disease fluid protein 15 (d), while showing negative staining for cytokeratin 20 (e) and E-cadherin (f).
case_images: cureus-0016-00000052765-i04.jpg
case_images: PMC10882214_01_cureus-0016-00000052765-i04.jpg
case_images: FIG4
case_images: The pathology results of the biopsy specimens from both the gastric and colonic lesions revealed poorly differentiated adenocarcinoma with distinctive signet ring cell features (Figure 4a). Immunohistochemical (IHC) staining of the colonic lesion further confirmed that tumor cells were positive for cytokeratin 7 (CK7), GATA-binding protein 3, ER, and gross cystic disease fluid protein 15 (GCDFP-15) and negative for cytokeratin 20 (CK20) and E-cadherin (Figures 4b-4f).
case_images: Abdominal CT images after anastrozole and palbociclib therapy.. A metastatic lesion in the ascending colon (indicated by the arrow) shows no obvious tumor enlargement (a, b, c).
case_images: cureus-0016-00000052765-i05.jpg
case_images: PMC10882214_01_cureus-0016-00000052765-i05.jpg
case_images: FIG5
case_images: The initial CT scan performed in month two showed no obvious tumor enlargement of the ascending metastases, as defined by the Response Evaluation Criteria in Solid Tumors version 1.1 (Figure 5).
case_images: Colonoscopy image after anastrozole and palbociclib therapy.. Colonoscopy shows a reduction of edematous folds and the disappearance of intestinal stenosis of the ascending (a) and sigmoid colon (b).
case_images: cureus-0016-00000052765-i06.jpg
case_images: PMC10882214_01_cureus-0016-00000052765-i06.jpg
case_images: FIG6
case_images: Notably, colonoscopy showed a notable reduction in the edematous folds and the disappearance of intestinal stenosis (Figure 6).
case_images: Upper endoscopy after anastrozole and palbociclib therapy.. Upper endoscopy reveals a reduction and indistinctness of the metastatic lesion in angulus (a, b) (indicated by the arrow). Magnifying blue laser imaging shows a shrinkage of an irregular surface pattern with irregular microvasculature in the tumor lesion (c).
case_images: cureus-0016-00000052765-i07.jpg
case_images: PMC10882214_01_cureus-0016-00000052765-i07.jpg
case_images: FIG7
case_images: Similarly, GI endoscopy showed a reduction in the size of the multiple depressed lesions (Figure 7).