Article Figures & Data
Figures
- Figure 1.
Manual muscle test (MMT) of the right and left upper extremities. A) At the initial visit to our hospital, the MMT scores of the deltoid, biceps, and triceps muscles of the right upper extremity were all 5/5. Despite posterior stabilization, muscle weakness in the right upper limb progressed, and the right extremities could hardly move. However, chemotherapy dramatically improved the patient’s muscle weakness. With the continuation of chemotherapy, the movement of the upper right limb gradually improved. The squares represent biceps, the triangles represent triceps, and the arrows represent deltoid. B) At the initial visit to our hospital, the MMT scores of the left deltoid and triceps muscles of the left upper extremity was 2/5, while the score of the left biceps muscle was 1/5. The left upper extremity was originally recognized to have lost muscle strength earlier, and the muscle strength of the left upper extremity took longer to improve in comparison to the muscle strength of the right upper extremity. Nevertheless, chemotherapy gradually improved the movement of his left extremity. The squares represent biceps, the triangles represent triceps, and the arrows represent deltoid.
- Figure 2.
Osteolytic masses extended to the vertebral arch in the C5, C6, C7, and Th3 vertebral bodies (arrow).
- Figure 3.
Thickening of the sigmoid colon was observed from the rectal area, and the boundary with the surrounding fat was unclear on computed tomography, suggesting colorectal cancer (arrow).
- Figure 4.
Pathology of colorectal cancer and vertebra. A) Pathology of colorectal cancer. 1. Atypical cells grew in alveolar foci. Glandular formation was unclear, suggesting poorly differentiated adenocarcinoma (HE staining, ×200). 2. Cytokeratin 7 (CK7) negative (CK7 staining). 3. Cytokeratin 20 (CK20) negative (CK20 staining). Most colorectal cancers are CK7-negative and CK20-positive; thus, this case was not typical. B) Pathology of vertebra. 1. The tumor proliferated like an alveolus with some small glandular formations, suggesting moderately to poorly differentiated adenocarcinoma (HE staining, ×200). It was suspected that it was a metastatic lesion, but at this point it was not known where the metastasis came from. 2. CK7 negative (CK7 staining, ×200). 3. CK20 negative (CK20 staining, ×200). Negative results for CK7 and CK20 were consistent with colorectal cancer findings. 4. CDX2 positive. Diffuse nuclear positivity (CK20 staining, ×200). A positive CDX2 resulted in a diagnosis of colorectal cancer.
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