case_images: PMC11829512_01
case_images: Mammogram of the right breast showing a transversely palpable marker overlying the right upper outer quadrant. There is nodule and 1.4 cm mass, which persists on spot compression at approximately 10-11 o'clock position (red arrow).
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case_images: PMC11829512_01_cureus-0017-00000077534-i01.jpg
case_images: FIG1
case_images: Ultrasound of the right breast showed a 1.2 x 0.9 x 1.4 cm suspicious age-related mass (blue arrow) at 10-11 o'clock position, 5 cm from the nipple. Both axillae are imaged and are normal.
case_images: cureus-0017-00000077534-i02.jpg
case_images: PMC11829512_01_cureus-0017-00000077534-i02.jpg
case_images: FIG2
case_images: A semi-circumferential, non-obstructive, ulcerated, friable mass measuring approximately 4 x 6.5 cm was found in the proximal ascending colon, with overlying friable and ulcerated mucosa, during colonoscopy (blue arrows).
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case_images: PMC11829512_01_cureus-0017-00000077534-i03.jpg
case_images: FIG3
case_images: In July 2023, she underwent a diagnostic colonoscopy that showed a semi-circumferential (65% extent), ulcerated, friable mass measuring approximately 4 x 6.5 cm at the proximal ascending colon, with overlying friable and ulcerated mucosa (Figure 3).
case_images: Hematoxylin & eosin staining in 100x magnification showing metastasis in lymph node with invasive colonic adenocarcinoma.
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case_images: PMC11829512_01_cureus-0017-00000077534-i04.jpg
case_images: FIG4
case_images: The final surgical pathology report showed invasive adenocarcinoma of the colon (Figure 4 and Figure 5) with moderate- to high-grade differentiation, measuring 4 x 3.5 x 2 cm.
case_images: Hematoxylin & eosin staining in 100x magnification showing invasive colonic adenocarcinoma with adjacent benign appearing mucosa.
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case_images: PMC11829512_01_cureus-0017-00000077534-i05.jpg
case_images: FIG5
case_images: The final surgical pathology report showed invasive adenocarcinoma of the colon (Figure 4 and Figure 5) with moderate- to high-grade differentiation, measuring 4 x 3.5 x 2 cm.
case_images: CT abdomen and pelvis with contrast showing a moderately distended gallbladder with mild wall enhancement and pericholecystic inflammatory changes (red arrow). Acute cholecystitis cannot be excluded.
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case_images: FIG6
case_images: A CT scan of the abdomen and pelvis with contrast (Figure 6) showed pericholecystic inflammatory changes.
case_images: An MRCP image showing mild dilatation of the CBD measuring 8 mm with an abrupt cutoff of the common duct just proximal to the ampulla, which likely represents some internal sludge or small ductal stone or inflammatory stricture (red arrow).. CBD, common bile duct; MRCP, magnetic resonance cholangiopancreatography
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case_images: PMC11829512_01_cureus-0017-00000077534-i07.jpg
case_images: FIG7
case_images: MRI with a pancreatic protocol showed the pancreas to be mildly atrophic with mild prominence of the pancreatic duct. A cyst was noted in the pancreatic head (A, red arrow) and an additional cyst in the pancreatic tail (B, blue arrow), likely representing a small IPMN.. MRI, magnetic resonance imaging; IPMN, pancreatic Intraductal papillary mucinous neoplasm
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case_images: PMC11829512_01_cureus-0017-00000077534-i08.jpg
case_images: FIG8
case_images: A cyst was identified in the pancreatic head (Figure 8A, red arrow) and an additional cyst in the pancreatic tail (Figure 8B, blue arrow), likely representing a small IPMN.
case_images: EUS showing CBD dilation to 9.8 mm (A). No stones, sludge, strictures, masses, or abrupt cutoffs were noted in the CBD; therefore, ERCP was not performed. Additionally, two anechoic cysts were found: one in the pancreatic head and the other in the pancreatic body, measuring 9.0 x 6.1 mm and 8.7 x 7.8 mm, respectively (B and C).. EUS, endoscopic ultrasound; CBD, common bile duct; ERCP, endoscopic retrograde cholangiopancreatography
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case_images: PMC11829512_01_cureus-0017-00000077534-i09.jpg
case_images: FIG9
case_images: The patient was evaluated by a gastroenterologist (GI) specialist and underwent an endoscopic ultrasound (EUS) showing CBD dilation to 9.8 mm(Figure 9A). Additionally, two anechoic cysts were found: one in the head and the other in the body of the pancreas, measuring 9.0 x 6.1 mm and 8.7 x 7.8 mm, respectively (Figures 9B, 9C).