Moderately to poorly differentiated adenocarcinoma invading a leiomyoma: A case report

Table 1 Tumor markers

Marker	Status	Result	Unit	Reference range
Tumor markers
CYFRA21-1	↑	3.95	ng/mL	0.10-3.30
Lipid profile
TC	↑	6.21	mmol/L	< 5.18
TG	↑	1.72	mmol/L	0.56-1.70
HDL-C	↓	1.01	mmol/L	> 1.04
LDL-C	↑	4.44	mmol/L	< 3.37
Apo B	↑	1.46	g/L	0.6-1.4
sdLDL	↑	1.82	mmol/L	0.25-1.17
Inflammation and others
ALB	↓	39.6	g/L	40.0-55.0
Hs-CRP	↑	3.68	mg/L	< 1.00
Serolog
HBcAb	Positive	4.12	IU/mL	0-0.35

TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein; LDL-C: Low-density lipoprotein; Apo B: Apolipoprotein B; sdLDL: Small dense low-density lipoprotein; ALB: Albumin; Hs-CRP: High-sensitivity C-reactive protein; HBcAb: Hepatitis B core antibody.

Table 2 Immunohistochemistry

Marker	Result	Clinical significance
Panel A: Mesenchymal tumor differentiation
SMA	Positive	Supports leiomyoma origin
Desmin	Positive	Supports leiomyoma origin
CD117 (KIT)	Focally positive	Helps rule out GIST
DOG-1	Negative	Helps rule out GIST
SDHB	Intact	Rules out SDH-deficient GIST
CD34	Negative/intact vascular staining	Not typical for GIST in this context/no evidence of lymphovascular invasion identified
S-100	Negative/nerves highlighted	Helps rule out schwannoma/no perineural invasion identified
Panel B: Epithelial tumor characterization
CK7	Positive	Consistent with gastric origin
CK20	Rarely positive	Common profile for gastric adenocarcinoma
Mucin-2	Negative	Suggests intestinal-type differentiation
Mucin 5AC	Focally positive	Suggests gastric/gastrointestinal differentiation
Mucin 6	Rarely positive	Suggests gastric differentiation
CDX-2	Positive	Supports intestinal-type differentiation
Panel C: Proliferation and tumor suppressor markers
Ki-67	1%-5% +/80% (in hotspot regions)	Indicates a high proliferative index
P53	90% positive, located in the cell nucleus. Positive tumor cells account for approximately 85%	Suggests underlying TP53 gene mutation
Her-2	(1+) negative, positive tumor cells account for approximately 10%	May have implications for targeted therapy
MSH-6	(+) located in the cell nucleus. Positive tumor cells account for approximately 10%	The mismatch repair function is missing
MlH-1	(+) located in the cell nucleus. Positive tumor cells account for approximately 95%	Prompt to save the mismatch repair function

SMA: Smooth muscle actin; KIT: Proto-oncogene receptor tyrosine kinase; DOG-1: Discovered on gastrointestinal stromal tumor-1; SDHB: Succinate dehydrogenase B; CK: Cytokeratin; CDX-2: Caudal-type homeobox 2; MSH-6: MutS homolog 6; MlH-1: MutL homolog 1; GIST: Gastrointestinal stromal tumors; SDH: Succinate dehydrogenase.