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case_images: Pedigree of the family. The arrow ( ) points to the proband. Squares and circles respectively represent males and females. Roman numerals indicate generations. Solid symbols represent cancer patients. Symbols with a slash indicate deceased individuals. The number below shows the initial onset age. Patient number II2 is the proband. Patients number I1and I2 suffered from colon cancer at the age of 60. Patient number II1 suffered from malignant melanoma of the perineum at the age of 80. Patient number II5 suffered from colon cancer at the age of 50. Patients number II10 and III3 suffered from colon cancer before the age of 50. Furthermore, patient number II10 also suffered from transverse colon carcinoma at the age of 57. Patient number III4 suffered from ovarian cancer at 40, and breast carcinoma at 47.
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case_images: In addition, a son of one of his sisters was also diagnosed with colon cancer, and a daughter of one of his brothers was also diagnosed with ovarian cancer at 40, and breast carcinoma at 47 ( Figure 1 ).
case_images: (A, B) The needle core biopsies of the prostate show a high-grade prostatic adenocarcinoma. (A, hematoxylin-eosinx100; B, hematoxylin-eosinx200). (C-F) Absence of MSH2 and MSH6 staining, and positive staining for MLH1and PMS2 in the prostatic tumor (original magnifications x200). (G-J) Absence of MSH2 and MSH6 staining, and positive staining for MLH1and PMS2 in the malignant peripheral nerve sheath tumor (original magnifications x200).
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case_images: Histopathology revealed high-grade prostatic adenocarcinoma ( Figures 2A, B ), and Gleason Score 4 + 5 = 9. Immunohistochemistry for prostate cancer was positive for MLH1 and PMS2, but negative for MSH2 and MSH6 ( Figures 2C - F ). Immunohistochemistry of the malignant peripheral nerve sheath tumor was positive for MLH1 and PMS2 but negative for MSH2 and MSH6 ( Figures 2G - J ).
case_images: Computed tomography (CT) demonstrated a malignant tumor in the right groin area, and the size of the mass was approximately 6.3 cm x 3.1 cm x 2.0 cm. (A) Imaging in the coronal section. (B) Tomography scan in the transverse section of the lesion.
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case_images: November 29, CT ( Figure 3 ) revealed that the right inguinal mass was larger than before, and the size of the mass was approximately 6.3 cm x 3.1 cm x 2.0 cm. Needle-core biopsy of the right inguinal mass was performed a week later.
case_images: The needle core biopsies of the malignant peripheral nerve sheath tumor. (A) Medium-power image of the tumor area shows spindle-cell tumors with dense arrangement and fascicular hyperplasia (hematoxylin-eosinx200). (B) High-power image of the tumor area shows that the nuclei of the tumor cells are deeply stained, irregular in shape, tadpole-like at the ends, and mitotic figures are readily apparent. (C) The tumor cells showed pleomorphism, and large pleomorphic cells were observed in some areas. (D) In the sparse cell area, the cell morphology was mostly elongated and wavy. (B-D; hematoxylin-eosinx400).
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case_images: Pathological examination revealed spindle-cell tumors ( Figure 4 ).