1. Case Summary 47세 여자 C.C.: hematochezia (내원 3일 전) Colonoscopy:
large round mass with surface erosion and oozing at the 40cm from anal verge
Surrounding mucosa was severely congested and had tortous vein

2. Papillary serous carcinoma
Right: axial image로 long arrow – sigmoid lumen내로 stalk-like하게 extension한 부위, short arrow – sigmoid colon, mass는 후방으로
Left: coronal reconstruction image로 short arrow – sigmoid colon, mass는 상부에 큰 것

13. cytokeratin

14. vimentin

15. Diagnosis
Colon, sigmoid, segmental resection: Papillary serous carcinoma, metastatic
Operation: grossly no ovarian abnormality
2005년 6월 소화기병리연구회 의견: mesothelioma vs papillary serous carcinoma, metastatic or primary

16. Follow-up 1달 후 다른 병원에서 bilateral oophorectomy 시행: normal ovaries
Immunohistochemistry: PEM vs PSC
Calretinin: 100% vs 31% (-)
D2-40: 93% vs 13% (-)
Podoplanin: 93% vs 13% (-)
ER: 0% vs 86% (+)
PR: 0% vs 56% (-)

17. ER

18. Final Diagnosis
Primary peritoneal papillary serous carcinoma