Synchronous multiple primary gastrointestinal cancers with CDH1 mutations: A case report

Figure 1 Endoscopy results. Multiple small polypoid lesions without stalk were observed in A: The stomach; B: The duodenum; C: The colon; D: The rectum.

Figure 2 Computed tomography findings. A-D: Computed tomography images not revealing substantial evidence for the existance of malignant lesions in the gastrointestinal wall.

Figure 3 Morphology and immunophenotype of the lesion. A: H&E staining showed poorly differentiated signet ring carcinoma; B: Tumor cells were negative for E-cadherin; C: β-catenin was translocated from the membrane to the cytoplasm and nucleus in malignant cells; D: Periodic acid Schiff (PAS) staining revealed the presence of mucin in the cytoplasm of signet ring cells. Original magnification, ×400.

Figure 4 CDH1 sequencing. Two base substitutions were confirmed in the CDH1 gene: C.57 T>G and C.1418 A>T.