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                tissue microarray-SMCRAC220XM
                • Cores:
                  110
                  CASES:
                  54
                  Core Diameter(mm):
                  1
                  Thickness(µm):
                  5
                  Row number:
                  11
                  Column number:
                  10
                  Tissue Array Type:
                  FFPE
                  Species:
                  Human
                SMCRAC220XM
                $2350.00
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                Description: Colon cancer tissue array, including pathology grade, TNM, clinical stage,IHC results, Molecular testing / Genetic testing, Family history, Treatment and Prognosis, 54 cases/110 cores

                Details: Colon carcinoma tissue microarray, containing 30 cases of colon carcinoma with matched metastatic cancer, 13 colon carcinoma with matched metastatic cancer and cancer adjacent colon tissue, 11 colon carcinoma, single cores per case

                Applications: Routine histology procedures including Immunohistochemistry (IHC) and In Situ Hybridization (ISH), protocols which can be found at our support page

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                110 Cores54 CasesColon Adjacent special price single core per case
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                Note

                1. TMA slides were sectioned and stored at 4°C and may not be fresh cut, but still suitable for IHC. Please request fresh cut if experiment involves phospho-specific antibodies, RNA studies, FISH or ISH, etc. A minimum of 3 slides per TMA must be purchased to cover the cost of trimming for fresh sectioning.
                2. Most TMA slides were not coated with an extra layer of paraffin (tissue cores can be easily seen on the glass). To prevent tissue detachment during antigen retrieval, unbaked slides must be baked for at least 30 to 120 minutes at 60°C. before putting into xylene for de-paraffinization. Baked slides were sent out baked for 2 hours.
                In the following specsheet,“*” means invalid core; “-” means no applicable or negative in IHC markers."

                • Specification sheet
                • Overlapping case
                • Download specifications
                Legend:
                col-colon Lym-Lymph node *-*
                • AT(IIIA)
                • Metastasis(IIIC)
                • *(*)
                • AT(IIIC)
                • Metastasis(IIB)
                • AT(IIB)
                • AT(IVA)
                • Metastasis(IIIB)
                • AT(IIIB)
                • Metastasis(IVA)
                • Metastasis(IVB)
                • Metastasis(IIC)
                • AT(IVB)
                • Malignant(IVC)
                • Metastasis(IIIA)
                • Metastasis(IVC)
                • Malignant(I)
                • Malignant(IIB)
                • Malignant(IIC)
                • Malignant(IIIA)
                • Malignant(IIIB)
                • Malignant(IIIC)
                • Malignant(IVA)
                • Malignant(IVB)
                https://www.arraysbank.com/tissue-arrays

                TISSUE ARRAYS
                SMCRAC220XM
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                SMCRAC220XM
                • Age:
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                • Organ/Anatomic Site:
                • Pathology diagnosis:
                • Grade:
                • TNM:
                • Stage:
                • Tissue ID.:
                • Type:
                Pos No. Age Sex Organ/Anatomic Site Pathology diagnosis Grade TNM Stage Type General observations Immunohistochemical results Therapeutic drug Family history Follow Up Molecular testing / Genetic testing
                A1
                		 1 F 71 colon Colon cancer * T3N1aM1a IVA Malignant Sigmoid colon resection specimen: a segment of bowel measuring 12 cm in length and 3.5 cm in diameter. An ulcerated mass is identified 3.2 cm from one resection margin and 3.5 cm from the opposite margin, measuring 4.8 × 4.5 cm, with raised edges up to 1.0 cm in height. HER2: 1+; CDX2: positive. MMR proteins preserved (proficient MMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab Both parents deceased; father died of colon cancer. Deceased (10 months postoperatively) *
                A2
                		 2 F 71 colon Metastasis liver cancer from colon * T3N1aM1a IVA Metastasis Sigmoid colon resection specimen: a segment of bowel measuring 12 cm in length and 3.5 cm in diameter. An ulcerated mass is identified 3.2 cm from one resection margin and 3.5 cm from the opposite margin, measuring 4.8 × 4.5 cm, with raised edges up to 1.0 cm in height. HER2: 1+; CDX2: positive. MMR proteins preserved (proficient MMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab Both parents deceased; father died of colon cancer. Deceased (10 months postoperatively) *
                A3
                		 3 F 70 colon Colon cancer * T4bN0M0 IIC Malignant Right hemicolectomy specimen with attached liver tissue. The specimen includes 8 cm of terminal ileum (2 cm in diameter) and 22 cm of colon (2–6 cm in diameter). A polypoid/exophytic mass is identified 15 cm from the ileal resection margin and 12 cm from the colonic resection margin, measuring 5.8 × 5.0 cm. The serosal surface is focally adherent to a small fragment of liver tissue measuring 2.0 × 1.3 × 1.3 cm. The ileocecal region contains an appendix measuring 3.3 cm in length and 0.8 cm in diameter. CDX2: positive; HER2: 2+. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). CD34 and D2-40: no evidence of lymphovascular invasion by staining. Ki-67 labeling index ~80%. S-100 staining supports perineural invasion. Oxaliplatin + capecitabine + bevacizumab Both parents deceased; cause unknown. Alive KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                A4
                		 4 F 70 colon Metastasis liver cancer from colon * T4bN0M0 IIC Metastasis Right hemicolectomy specimen with attached liver tissue. The specimen includes 8 cm of terminal ileum (2 cm in diameter) and 22 cm of colon (2–6 cm in diameter). A polypoid/exophytic mass is identified 15 cm from the ileal resection margin and 12 cm from the colonic resection margin, measuring 5.8 × 5.0 cm. The serosal surface is focally adherent to a small fragment of liver tissue measuring 2.0 × 1.3 × 1.3 cm. The ileocecal region contains an appendix measuring 3.3 cm in length and 0.8 cm in diameter. CDX2: positive; HER2: 2+. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). CD34 and D2-40: no evidence of lymphovascular invasion by staining. Ki-67 labeling index ~80%. S-100 staining supports perineural invasion. Oxaliplatin + capecitabine + bevacizumab Both parents deceased; cause unknown. Alive KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                A5
                		 5 F 54 colon Colon cancer * T3N2aM1a IVA Malignant Partial colectomy specimen: A segment of bowel measuring 15 cm in length and 4.0 cm in diameter. An ulcerated, circumferential mass encircling the bowel wall is identified 4.5 cm from the proximal resection margin and 5.0 cm from the distal resection margin, measuring 4.5 × 3.0 cm. Partial hepatectomy specimen (posterior right lobe): One piece of liver tissue measuring 10 × 8 × 5 cm. Sectioning reveals a mass measuring 4.5 × 4.0 cm, with a gray-white to gray-red cut surface and partial capsule. HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                A6
                		 6 F 54 colon Metastasis liver cancer from colon * T3N2aM1a IVA Metastasis Partial colectomy specimen: A segment of bowel measuring 15 cm in length and 4.0 cm in diameter. An ulcerated, circumferential mass encircling the bowel wall is identified 4.5 cm from the proximal resection margin and 5.0 cm from the distal resection margin, measuring 4.5 × 3.0 cm. Partial hepatectomy specimen (posterior right lobe): One piece of liver tissue measuring 10 × 8 × 5 cm. Sectioning reveals a mass measuring 4.5 × 4.0 cm, with a gray-white to gray-red cut surface and partial capsule. HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                A7
                		 7 M 40 colon Colon cancer * T4aN2bM1c IVC Malignant Rectal resection specimen: A segment of bowel measuring 10 cm in length and 2–3 cm in diameter. An ulcerated mass is identified 3.0 cm from one resection margin and 3.5 cm from the opposite margin, measuring 4.0 × 3.0 × 0.5 cm. Additional specimens submitted: (Abdominal wall nodule) One irregular tissue fragment measuring 0.8 × 0.5 × 0.3 cm. (Abdominal wall metastatic nodule) Two irregular tissue fragments, aggregate 1.5 × 1.0 × 0.5 cm. (Liver metastatic nodule) One piece of liver tissue measuring 4.5 × 4.0 × 3.0 cm; sectioning reveals a mass measuring 5.0 × 1.3 × 1.2 cm. HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab, later adjusted to include immunotherapy (camrelizumab) (exact dates not available). Both parents alive. Alive, with multiple recurrences. *
                A8
                		 8 M 40 colon Metastasis liver cancer from colon * T4aN2bM1c IVC Metastasis Rectal resection specimen: A segment of bowel measuring 10 cm in length and 2–3 cm in diameter. An ulcerated mass is identified 3.0 cm from one resection margin and 3.5 cm from the opposite margin, measuring 4.0 × 3.0 × 0.5 cm. Additional specimens submitted: (Abdominal wall nodule) One irregular tissue fragment measuring 0.8 × 0.5 × 0.3 cm. (Abdominal wall metastatic nodule) Two irregular tissue fragments, aggregate 1.5 × 1.0 × 0.5 cm. (Liver metastatic nodule) One piece of liver tissue measuring 4.5 × 4.0 × 3.0 cm; sectioning reveals a mass measuring 5.0 × 1.3 × 1.2 cm. HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab, later adjusted to include immunotherapy (camrelizumab) (exact dates not available). Both parents alive. Alive, with multiple recurrences. *
                A9
                		 9 F 57 colon Colon cancer * T3N2bM1a IVA Malignant Right hemicolectomy specimen: The specimen includes 6 cm of ileum (2 cm in diameter) and 19 cm of colon (7 cm in diameter). A large ulcerated mass is identified in the ascending colon, located 10 cm from the ileal resection margin and 14 cm from the colonic resection margin, measuring 6.0 × 4.0 cm. The ileocecal region contains an appendix measuring 5.0 cm in length and 1.0 cm in diameter. Liver tissue: One piece of liver measuring 7 × 6 × 4 cm; on sectioning, a gray-yellow area/lesion measuring 3.5 × 3.0 cm is noted. Kidney with perinephric fat specimen: Measuring 9 × 4 × 4 cm. The cut surface shows a unilocular cystic change with a wall thickness of 0.2–0.5 cm; contents are lost. The renal hilar structures are indistinct. CDX2: positive. Ki-67 ~60% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. D2-40 and CD34 highlight lymphovascular invasion. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive; ascites developed 26 months postoperatively. *
                A10
                		 10 F 57 colon Metastasis liver cancer from colon * T3N2bM1a IVA Metastasis Right hemicolectomy specimen: The specimen includes 6 cm of ileum (2 cm in diameter) and 19 cm of colon (7 cm in diameter). A large ulcerated mass is identified in the ascending colon, located 10 cm from the ileal resection margin and 14 cm from the colonic resection margin, measuring 6.0 × 4.0 cm. The ileocecal region contains an appendix measuring 5.0 cm in length and 1.0 cm in diameter. Liver tissue: One piece of liver measuring 7 × 6 × 4 cm; on sectioning, a gray-yellow area/lesion measuring 3.5 × 3.0 cm is noted. Kidney with perinephric fat specimen: Measuring 9 × 4 × 4 cm. The cut surface shows a unilocular cystic change with a wall thickness of 0.2–0.5 cm; contents are lost. The renal hilar structures are indistinct. CDX2: positive. Ki-67 ~60% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. D2-40 and CD34 highlight lymphovascular invasion. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive; ascites developed 26 months postoperatively. *
                B1
                		 11 F 77 colon Colon cancer * T3N2aM1a IVA Malignant Right hemicolectomy specimen: The specimen includes 19 cm of ileum (2.2 cm in diameter) and 42 cm of colon (5.0 cm in diameter). An ulcerated mass is identified in the colon, located 43 cm from the ileal resection margin and 13 cm from the colonic resection margin, measuring 5.0 × 5.0 cm. The ileocecal region contains an appendix measuring 7.0 cm in length and 0.6 cm in diameter. (Hepatic metastatic lesion): One piece of liver tissue measuring 2.5 × 2.0 × 1.0 cm. A focal area on the surface is slightly gray-white and firm, measuring 1.0 × 1.0 cm. HER2: 0; CDX2: focally positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~60% positive. Oxaliplatin + capecitabine + bevacizumab Both parents deceased; cause unknown. Alive KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                B2
                		 12 F 77 colon Metastasis liver cancer from colon * T3N2aM1a IVA Metastasis Right hemicolectomy specimen: The specimen includes 19 cm of ileum (2.2 cm in diameter) and 42 cm of colon (5.0 cm in diameter). An ulcerated mass is identified in the colon, located 43 cm from the ileal resection margin and 13 cm from the colonic resection margin, measuring 5.0 × 5.0 cm. The ileocecal region contains an appendix measuring 7.0 cm in length and 0.6 cm in diameter. (Hepatic metastatic lesion): One piece of liver tissue measuring 2.5 × 2.0 × 1.0 cm. A focal area on the surface is slightly gray-white and firm, measuring 1.0 × 1.0 cm. HER2: 0; CDX2: focally positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~60% positive. Oxaliplatin + capecitabine + bevacizumab Both parents deceased; cause unknown. Alive KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                B3
                		 13 M 88 colon Colon cancer * T4aN1aM1a IVA Malignant Left hemicolectomy with partial sigmoid colectomy specimen: A segment of bowel measuring 15.5 cm in length and 4.5 cm in diameter. An ulcerated mass is identified 3.0 cm from one resection margin and 10.0 cm from the opposite margin, measuring 5.0 × 4.0 cm. Liver tumor resection specimen: One irregular gray-yellow tissue fragment measuring 6.0 × 4.5 × 4.0 cm. On sectioning, a gray-white mass measuring 5.5 × 3.8 cm is present. The cut surface is gray-white and solid, and the lesion is very close to the hepatic resection margin. CDX2: positive; HER2: 1+ (negative). MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). SALL4: negative; Glypican-3: negative; AFP: negative. CD31 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80%. S-100 staining supports perineural invasion. Oxaliplatin + capecitabine + bevacizumab Both parents deceased; cause unknown. Alive (4 months postoperatively). *
                B4
                		 14 M 88 colon Metastasis liver cancer from colon * T4aN1aM1a IVA Metastasis Left hemicolectomy with partial sigmoid colectomy specimen: A segment of bowel measuring 15.5 cm in length and 4.5 cm in diameter. An ulcerated mass is identified 3.0 cm from one resection margin and 10.0 cm from the opposite margin, measuring 5.0 × 4.0 cm. Liver tumor resection specimen: One irregular gray-yellow tissue fragment measuring 6.0 × 4.5 × 4.0 cm. On sectioning, a gray-white mass measuring 5.5 × 3.8 cm is present. The cut surface is gray-white and solid, and the lesion is very close to the hepatic resection margin. CDX2: positive; HER2: 1+ (negative). MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). SALL4: negative; Glypican-3: negative; AFP: negative. CD31 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80%. S-100 staining supports perineural invasion. Oxaliplatin + capecitabine + bevacizumab Both parents deceased; cause unknown. Alive (4 months postoperatively). *
                B5
                		 15 F 33 colon Colon cancer * T4aN2aMla IVA Malignant Left hemicolectomy specimen: A segment of bowel measuring 22 cm in length and 7.5 cm in diameter. An ulcerated mass (lesion #1) is identified 5.0 cm from one resection margin and 12.5 cm from the opposite margin, measuring 6.5 × 4.0 cm. Adjacent to lesion #1 is a cluster of cauliflower-like (exophytic) masses (lesion #2) with an aggregate size of 7.0 × 5.0 × 3.0 cm, adherent to lesion #1. Three perforation sites are noted at 5.0 cm, 11.0 cm, and 13.5 cm from one resection margin; these sites have been sutured clinically. Liver specimen (left lateral segment): One lobe of liver measuring 12 × 9 × 6 cm. On sectioning, a firm gray-white nodule measuring 4.0 × 2.5 cm is identified, involving the capsule; the cut surface is gray-yellow and tough/fibrous. (Partial greater omentum): One piece of omental tissue measuring 13 × 1 × 1 cm, with no grossly apparent abnormality. HER2: 1+; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab. Mother alive; father with lung adenocarcinoma. Alive *
                B6
                		 16 F 33 colon Metastasis liver cancer from colon * T4aN2aMla IVA Metastasis Left hemicolectomy specimen: A segment of bowel measuring 22 cm in length and 7.5 cm in diameter. An ulcerated mass (lesion #1) is identified 5.0 cm from one resection margin and 12.5 cm from the opposite margin, measuring 6.5 × 4.0 cm. Adjacent to lesion #1 is a cluster of cauliflower-like (exophytic) masses (lesion #2) with an aggregate size of 7.0 × 5.0 × 3.0 cm, adherent to lesion #1. Three perforation sites are noted at 5.0 cm, 11.0 cm, and 13.5 cm from one resection margin; these sites have been sutured clinically. Liver specimen (left lateral segment): One lobe of liver measuring 12 × 9 × 6 cm. On sectioning, a firm gray-white nodule measuring 4.0 × 2.5 cm is identified, involving the capsule; the cut surface is gray-yellow and tough/fibrous. (Partial greater omentum): One piece of omental tissue measuring 13 × 1 × 1 cm, with no grossly apparent abnormality. HER2: 1+; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 staining supports perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab. Mother alive; father with lung adenocarcinoma. Alive *
                B7
                		 17 F 77 colon Colon cancer * T3N1aM1a IVA Malignant Right hemicolectomy specimen: The specimen includes 13 cm of ileum (2.0 cm in diameter) and 25 cm of colon (3–5 cm in diameter). A large ulcerated mass is present at the hepatic flexure, located 21 cm from the ileal resection margin and 7 cm from the colonic resection margin, measuring 8.5 × 5.5 cm with a 1.0 cm central depression; the lesion extends to/approaches the serosal surface. Two additional polypoid lesions are identified: one measuring 1.0 × 1.0 cm located 2.0 cm from the colonic resection margin, and another measuring 0.5 × 0.3 cm located 4.5 cm from the colonic resection margin. The ileocecal region contains an appendix measuring 5.5 cm in length and 0.6 cm in diameter, containing an appendicolith (fecalith). Additional specimen submitted: (Hepatic metastatic lesion) One irregular gray-red tissue fragment measuring 1.6 × 1.2 × 0.7 cm with a firm gray-white cut surface. HER2: 1+ (negative); CDX2: weakly positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents deceased; cause unknown. Alive KRAS mutation present (exon 2, codon 12). NRAS: no mutation detected. BRAF V600E: no mutation detected.
                B8
                		 18 F 77 colon Metastasis liver cancer from colon * T3N1aM1a IVA Metastasis Right hemicolectomy specimen: The specimen includes 13 cm of ileum (2.0 cm in diameter) and 25 cm of colon (3–5 cm in diameter). A large ulcerated mass is present at the hepatic flexure, located 21 cm from the ileal resection margin and 7 cm from the colonic resection margin, measuring 8.5 × 5.5 cm with a 1.0 cm central depression; the lesion extends to/approaches the serosal surface. Two additional polypoid lesions are identified: one measuring 1.0 × 1.0 cm located 2.0 cm from the colonic resection margin, and another measuring 0.5 × 0.3 cm located 4.5 cm from the colonic resection margin. The ileocecal region contains an appendix measuring 5.5 cm in length and 0.6 cm in diameter, containing an appendicolith (fecalith). Additional specimen submitted: (Hepatic metastatic lesion) One irregular gray-red tissue fragment measuring 1.6 × 1.2 × 0.7 cm with a firm gray-white cut surface. HER2: 1+ (negative); CDX2: weakly positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents deceased; cause unknown. Alive KRAS mutation present (exon 2, codon 12). NRAS: no mutation detected. BRAF V600E: no mutation detected.
                B9
                		 19 F 80 colon Colon cancer * T4aN2aMla IVA Malignant Right hemicolectomy specimen: The specimen includes ileum measuring 15.8 cm in length (1.8–2.2 cm in diameter) and colon measuring 22.5 cm in length (3.2–4.5 cm in diameter). A large ulcerated mass is identified 6.2 cm from the colonic resection margin, measuring 11.5 × 5.8 cm. The ileocecal region contains an appendix measuring 6.5 cm in length (0.8–1.0 cm in diameter); the appendiceal serosa is congested/hyperemic. Liver nodule: A partial liver tissue fragment measuring 3.2 × 2.2 × 1.5 cm; sectioning reveals a gray-white focus measuring approximately 0.4 × 0.4 cm. CD56: negative; Chromogranin A (CgA): negative; Synaptophysin (Syn): negative. S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 proliferation index ~70%. Oxaliplatin + capecitabine + bevacizumab. Both parents deceased; cause unknown. Alive *
                B10
                		 20 F 80 colon Metastasis liver cancer from colon * T4aN2aMla IVA Metastasis Right hemicolectomy specimen: The specimen includes ileum measuring 15.8 cm in length (1.8–2.2 cm in diameter) and colon measuring 22.5 cm in length (3.2–4.5 cm in diameter). A large ulcerated mass is identified 6.2 cm from the colonic resection margin, measuring 11.5 × 5.8 cm. The ileocecal region contains an appendix measuring 6.5 cm in length (0.8–1.0 cm in diameter); the appendiceal serosa is congested/hyperemic. Liver nodule: A partial liver tissue fragment measuring 3.2 × 2.2 × 1.5 cm; sectioning reveals a gray-white focus measuring approximately 0.4 × 0.4 cm. CD56: negative; Chromogranin A (CgA): negative; Synaptophysin (Syn): negative. S-100 staining supports perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 proliferation index ~70%. Oxaliplatin + capecitabine + bevacizumab. Both parents deceased; cause unknown. Alive *
                C1
                		 21 F 65 colon Colon cancer * T4aN2bM1a IVA Malignant Gallbladder: One gallbladder measuring 6.5 × 3.0 × 2.0 cm. The serosal surface is smooth and gray-green. The lumen contains dark green bile. The wall thickness is approximately 0.3 cm. The mucosal surface is gray-green and coarsely granular. Bowel segment (rectum): A segment of bowel measuring 18 cm in length. An exophytic (fungating) mass is identified 2.5 cm from one resection margin and 14 cm from the opposite margin, measuring 3.0 × 2.0 × 1.0 cm, with 1.0 cm elevation above the mucosal surface. The cut surface is gray-white and solid. MLH1(+), MSH2(+), MSH6(+), PMS2(+) Oxaliplatin + capecitabine + bevacizumab Both parents deceased; cause unknown. Deceased (42 months postoperatively) *
                C2
                		 22 F 65 colon Metastasis liver cancer from colon * T4aN2bM1a IVA Metastasis Gallbladder: One gallbladder measuring 6.5 × 3.0 × 2.0 cm. The serosal surface is smooth and gray-green. The lumen contains dark green bile. The wall thickness is approximately 0.3 cm. The mucosal surface is gray-green and coarsely granular. Bowel segment (rectum): A segment of bowel measuring 18 cm in length. An exophytic (fungating) mass is identified 2.5 cm from one resection margin and 14 cm from the opposite margin, measuring 3.0 × 2.0 × 1.0 cm, with 1.0 cm elevation above the mucosal surface. The cut surface is gray-white and solid. MLH1(+), MSH2(+), MSH6(+), PMS2(+) Oxaliplatin + capecitabine + bevacizumab Both parents deceased; cause unknown. Deceased (42 months postoperatively) *
                C3
                		 23 M 73 colon Colon cancer * T4bN0M0 IIC Malignant Right hemicolectomy specimen: The specimen includes 9 cm of ileum (1.0 cm in diameter) and 17 cm of colon (4.0 cm in diameter). An ulcerated mass is identified at the hepatic flexure, located 13 cm from the ileal resection margin and 10 cm from the colonic resection margin, measuring 4.0 × 3.0 cm. The serosal surface is covered/adherent to liver tissue, measuring 3.0 × 2.5 cm. The ileocecal region contains an appendix measuring 6.0 cm in length and 0.5 cm in diameter. CDX2: negative. Ki-67 labeling index ~70% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. D2-40 and CD34: no definite lymphovascular invasion by staining. Oxaliplatin + capecitabine; bevacizumab added starting with the third cycle. Both parents deceased; cause unknown. Alive. *
                C4
                		 24 M 73 colon Metastasis liver cancer from colon * T4bN0M0 IIC Metastasis Right hemicolectomy specimen: The specimen includes 9 cm of ileum (1.0 cm in diameter) and 17 cm of colon (4.0 cm in diameter). An ulcerated mass is identified at the hepatic flexure, located 13 cm from the ileal resection margin and 10 cm from the colonic resection margin, measuring 4.0 × 3.0 cm. The serosal surface is covered/adherent to liver tissue, measuring 3.0 × 2.5 cm. The ileocecal region contains an appendix measuring 6.0 cm in length and 0.5 cm in diameter. CDX2: negative. Ki-67 labeling index ~70% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. D2-40 and CD34: no definite lymphovascular invasion by staining. Oxaliplatin + capecitabine; bevacizumab added starting with the third cycle. Both parents deceased; cause unknown. Alive. *
                C5
                		 25 F 77 colon Colon cancer * T4bN1aM0 IIIC Malignant Right hemicolectomy specimen: The specimen includes 3 cm of ileum (2.0 cm in diameter) and 26 cm of colon (3.5 cm in diameter). An ulcerated lesion is identified 10 cm from the ileal resection margin and 16 cm from the colonic resection margin, measuring 15.0 × 2.0 cm. Multiple enlarged mesenteric lymph nodes are palpable, the largest measuring approximately 2.5 cm in diameter. The ileocecal region contains an appendix measuring 2.0 cm in length and 0.8 cm in diameter. Additional specimens submitted: (“Fifth” mass): One nodular specimen measuring 1.5 × 1.5 × 1.5 cm; cut surface shows a gray-white nodule measuring 1.0 × 1.0 cm. (“Seventh” mass): One specimen measuring 3.5 × 2.5 × 2.0 cm; cut surface shows a gray-white area measuring 2.5 × 2.0 cm. CDX2: positive. Ki-67 labeling index ~80% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. D2-40 and CD34 highlight lymphovascular invasion. Oxaliplatin + capecitabine + bevacizumab. Both parents deceased; cause unknown. Deceased (16 months postoperatively). *
                C6
                		 26 F 77 colon Metastasis liver cancer from colon * T4bN1aM0 IIIC Metastasis Right hemicolectomy specimen: The specimen includes 3 cm of ileum (2.0 cm in diameter) and 26 cm of colon (3.5 cm in diameter). An ulcerated lesion is identified 10 cm from the ileal resection margin and 16 cm from the colonic resection margin, measuring 15.0 × 2.0 cm. Multiple enlarged mesenteric lymph nodes are palpable, the largest measuring approximately 2.5 cm in diameter. The ileocecal region contains an appendix measuring 2.0 cm in length and 0.8 cm in diameter. Additional specimens submitted: (“Fifth” mass): One nodular specimen measuring 1.5 × 1.5 × 1.5 cm; cut surface shows a gray-white nodule measuring 1.0 × 1.0 cm. (“Seventh” mass): One specimen measuring 3.5 × 2.5 × 2.0 cm; cut surface shows a gray-white area measuring 2.5 × 2.0 cm. CDX2: positive. Ki-67 labeling index ~80% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. D2-40 and CD34 highlight lymphovascular invasion. Oxaliplatin + capecitabine + bevacizumab. Both parents deceased; cause unknown. Deceased (16 months postoperatively). *
                C7
                		 27 F 77 colon Cancer adjacent colon tissue * T4bN1aM0 IIIC AT Right hemicolectomy specimen: The specimen includes 3 cm of ileum (2.0 cm in diameter) and 26 cm of colon (3.5 cm in diameter). An ulcerated lesion is identified 10 cm from the ileal resection margin and 16 cm from the colonic resection margin, measuring 15.0 × 2.0 cm. Multiple enlarged mesenteric lymph nodes are palpable, the largest measuring approximately 2.5 cm in diameter. The ileocecal region contains an appendix measuring 2.0 cm in length and 0.8 cm in diameter. Additional specimens submitted: (“Fifth” mass): One nodular specimen measuring 1.5 × 1.5 × 1.5 cm; cut surface shows a gray-white nodule measuring 1.0 × 1.0 cm. (“Seventh” mass): One specimen measuring 3.5 × 2.5 × 2.0 cm; cut surface shows a gray-white area measuring 2.5 × 2.0 cm. CDX2: positive. Ki-67 labeling index ~80% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. D2-40 and CD34 highlight lymphovascular invasion. Oxaliplatin + capecitabine + bevacizumab. Both parents deceased; cause unknown. Deceased (16 months postoperatively). *
                C8
                		 28 M 57 colon Colon cancer * T4aN0M0 IIB Malignant Right hemicolectomy specimen: The specimen includes 6.5 cm of ileum (2.0 cm in diameter) and 11 cm of colon (circumference 8–12 cm). A large circumferential ulcerated mass is present adjacent to the ileocecal region, measuring 8.0 × 5.5 cm. The tumor perforates the colonic serosa and is focally adherent to liver tissue; another area of the serosal surface is adherent to a portion of bowel wall. The ileocecal region contains an appendix measuring 7.0 cm in length and 0.8 cm in diameter, with extensive mesoappendiceal fusion. A separate segment of bowel measuring 20 cm in length and 2.5 cm in diameter shows no gross mucosal abnormality. CD34 and D2-40: no evidence of lymphovascular invasion by staining. MLH1: negative; MSH6: negative; PMS2: positive; MSH2: focal equivocal (+/−). S-100 highlights perineural invasion. Ki-67 labeling index ~75%. Oxaliplatin + capecitabine + bevacizumab. Both parents alive Alive *
                C9
                		 29 M 57 colon Metastasis liver cancer from colon * T4aN0M0 IIB Metastasis Right hemicolectomy specimen: The specimen includes 6.5 cm of ileum (2.0 cm in diameter) and 11 cm of colon (circumference 8–12 cm). A large circumferential ulcerated mass is present adjacent to the ileocecal region, measuring 8.0 × 5.5 cm. The tumor perforates the colonic serosa and is focally adherent to liver tissue; another area of the serosal surface is adherent to a portion of bowel wall. The ileocecal region contains an appendix measuring 7.0 cm in length and 0.8 cm in diameter, with extensive mesoappendiceal fusion. A separate segment of bowel measuring 20 cm in length and 2.5 cm in diameter shows no gross mucosal abnormality. CD34 and D2-40: no evidence of lymphovascular invasion by staining. MLH1: negative; MSH6: negative; PMS2: positive; MSH2: focal equivocal (+/−). S-100 highlights perineural invasion. Ki-67 labeling index ~75%. Oxaliplatin + capecitabine + bevacizumab. Both parents alive Alive *
                C10
                		 30 M 57 colon Cancer adjacent colon tissue * T4aN0M0 IIB AT Right hemicolectomy specimen: The specimen includes 6.5 cm of ileum (2.0 cm in diameter) and 11 cm of colon (circumference 8–12 cm). A large circumferential ulcerated mass is present adjacent to the ileocecal region, measuring 8.0 × 5.5 cm. The tumor perforates the colonic serosa and is focally adherent to liver tissue; another area of the serosal surface is adherent to a portion of bowel wall. The ileocecal region contains an appendix measuring 7.0 cm in length and 0.8 cm in diameter, with extensive mesoappendiceal fusion. A separate segment of bowel measuring 20 cm in length and 2.5 cm in diameter shows no gross mucosal abnormality. CD34 and D2-40: no evidence of lymphovascular invasion by staining. MLH1: negative; MSH6: negative; PMS2: positive; MSH2: focal equivocal (+/−). S-100 highlights perineural invasion. Ki-67 labeling index ~75%. Oxaliplatin + capecitabine + bevacizumab. Both parents alive Alive *
                D1
                		 31 F 33 colon Colon cancer * T3N1bM1a IVA Malignant Partial resection specimen of colon and small intestine, measuring 23 × 16 × 15 cm in aggregate. The small intestine measures 20 cm in length and 2.0 cm in diameter. The colon measures 30 cm in length, with a circumference ranging from 9.0 to 4.0 cm. A cauliflower-like (exophytic) mass is identified 16 cm from the colonic resection margin, measuring 10.0 × 4.0 × 1.0 cm; the cut surface is gray-white and solid. An appendix measuring 5.5 cm in length is present. A raised lesion is noted at the ileocecal region, measuring 2.0 × 1.5 × 0.5 cm. MLH1(-),MSH2(-),MSH6(+),PMS2(-),S-100: no evidence of perineural invasion by staining. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Oxaliplatin + capecitabine + bevacizumab. Ascites developed 5 years after surgery; chemotherapy was adjusted to oxaliplatin + capecitabine + camrelizumab. Parents alive; one sister with colon cancer. Deceased (45 months postoperatively). KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                D2
                		 32 F 33 colon Metastasis liver cancer from colon * T3N1bM1a IVA Metastasis Partial resection specimen of colon and small intestine, measuring 23 × 16 × 15 cm in aggregate. The small intestine measures 20 cm in length and 2.0 cm in diameter. The colon measures 30 cm in length, with a circumference ranging from 9.0 to 4.0 cm. A cauliflower-like (exophytic) mass is identified 16 cm from the colonic resection margin, measuring 10.0 × 4.0 × 1.0 cm; the cut surface is gray-white and solid. An appendix measuring 5.5 cm in length is present. A raised lesion is noted at the ileocecal region, measuring 2.0 × 1.5 × 0.5 cm. MLH1(-),MSH2(-),MSH6(+),PMS2(-),S-100: no evidence of perineural invasion by staining. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Oxaliplatin + capecitabine + bevacizumab. Ascites developed 5 years after surgery; chemotherapy was adjusted to oxaliplatin + capecitabine + camrelizumab. Parents alive; one sister with colon cancer. Deceased (45 months postoperatively). KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                D3
                		 33 M 60 colon Colon cancer * T3N2bM1a IVA Malignant Right hemicolectomy specimen: The specimen includes 5 cm of ileum (2.0 cm in diameter) and 10 cm of colon (3.0 cm in diameter). An ulcerated mass is identified 8.0 cm from the colonic resection margin and 10.5 cm from the ileal resection margin, measuring 3.5 × 3.5 cm. The ileocecal region contains an appendix measuring 6.0 cm in length and 0.6 cm in diameter. Hepatic metastatic lesion: One irregular tissue fragment measuring 2.5 × 2.0 × 1.0 cm. MLH1(+), MSH2(+), MSH6(+), PMS2(+) (MMR proteins retained; pMMR). S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 proliferation index ~80%. Oxaliplatin + capecitabine, with bevacizumab added later (exact cycle not specified). Both parents alive. Deceased (21 months postoperatively). *
                D4
                		 34 M 60 colon Metastasis liver cancer from colon * T3N2bM1a IVA Metastasis Right hemicolectomy specimen: The specimen includes 5 cm of ileum (2.0 cm in diameter) and 10 cm of colon (3.0 cm in diameter). An ulcerated mass is identified 8.0 cm from the colonic resection margin and 10.5 cm from the ileal resection margin, measuring 3.5 × 3.5 cm. The ileocecal region contains an appendix measuring 6.0 cm in length and 0.6 cm in diameter. Hepatic metastatic lesion: One irregular tissue fragment measuring 2.5 × 2.0 × 1.0 cm. MLH1(+), MSH2(+), MSH6(+), PMS2(+) (MMR proteins retained; pMMR). S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 proliferation index ~80%. Oxaliplatin + capecitabine, with bevacizumab added later (exact cycle not specified). Both parents alive. Deceased (21 months postoperatively). *
                D5
                		 35 F 67 colon Colon cancer * T3N0M1a IVA Malignant Right hemicolectomy specimen: The specimen includes 19 cm of ileum (2.0 cm in diameter) and 23 cm of colon (4.0 cm in diameter). An ulcerated mass is identified 25 cm from the ileal resection margin and 13 cm from the colonic resection margin, measuring 2.8 × 2.0 cm, with focal surface defect/ulceration. The ileocecal region contains an appendix measuring 4.5 cm in length and 0.5 cm in diameter. (Liver tumor) Partial hepatectomy specimen: One piece of liver tissue measuring 4.0 × 3.5 × 3.0 cm. On sectioning, a mass measuring 2.3 × 1.6 cm is identified, with a gray-white to gray-yellow solid cut surface. HER2: 0; CDX2: focally positive; Ki-67 labeling index ~50% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. D2-40 and CD34 highlight lymphovascular invasion. Oxaliplatin + capecitabine + bevacizumab. Mother alive; father deceased (cause unknown). Deceased (16 months postoperatively). *
                D6
                		 36 F 67 colon Metastasis liver cancer from colon * T3N0M1a IVA Metastasis Right hemicolectomy specimen: The specimen includes 19 cm of ileum (2.0 cm in diameter) and 23 cm of colon (4.0 cm in diameter). An ulcerated mass is identified 25 cm from the ileal resection margin and 13 cm from the colonic resection margin, measuring 2.8 × 2.0 cm, with focal surface defect/ulceration. The ileocecal region contains an appendix measuring 4.5 cm in length and 0.5 cm in diameter. (Liver tumor) Partial hepatectomy specimen: One piece of liver tissue measuring 4.0 × 3.5 × 3.0 cm. On sectioning, a mass measuring 2.3 × 1.6 cm is identified, with a gray-white to gray-yellow solid cut surface. HER2: 0; CDX2: focally positive; Ki-67 labeling index ~50% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. D2-40 and CD34 highlight lymphovascular invasion. Oxaliplatin + capecitabine + bevacizumab. Mother alive; father deceased (cause unknown). Deceased (16 months postoperatively). *
                D7
                		 37 F 67 colon Cancer adjacent colon tissue * T3N0M1a IVA AT Right hemicolectomy specimen: The specimen includes 19 cm of ileum (2.0 cm in diameter) and 23 cm of colon (4.0 cm in diameter). An ulcerated mass is identified 25 cm from the ileal resection margin and 13 cm from the colonic resection margin, measuring 2.8 × 2.0 cm, with focal surface defect/ulceration. The ileocecal region contains an appendix measuring 4.5 cm in length and 0.5 cm in diameter. (Liver tumor) Partial hepatectomy specimen: One piece of liver tissue measuring 4.0 × 3.5 × 3.0 cm. On sectioning, a mass measuring 2.3 × 1.6 cm is identified, with a gray-white to gray-yellow solid cut surface. HER2: 0; CDX2: focally positive; Ki-67 labeling index ~50% positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. D2-40 and CD34 highlight lymphovascular invasion. Oxaliplatin + capecitabine + bevacizumab. Mother alive; father deceased (cause unknown). Deceased (16 months postoperatively). *
                D8
                		 38 M 60 colon Colon cancer * T4aN1bM0 IIIB Malignant Distal gastrectomy with partial hepatectomy, partial transverse colectomy, and “suspected gallbladder” specimen: The stomach measures 20 × 8 × 6 cm (lesser curvature 15 cm, greater curvature 30 cm). A raised/exophytic mass is identified 7 cm from the proximal gastric margin and adjacent to the distal gastric margin, measuring 10 × 9 × 6 cm. The cut surface is gray-white to gray-yellow and soft, with a central defect/ulceration measuring approximately 4 × 2 cm. The specimen is attached to partial liver tissue (6 × 3.5 × 1 cm) and a segment of transverse colon measuring 14 cm in length (2.5–3.0 cm in diameter). The transverse colon shows a perforation measuring 3.5 cm in diameter, located 4.5 cm from one resection margin and 6.5 cm from the opposite margin, and the perforation communicates with the tumor. A “suspected gallbladder” measures 5.5 × 2.5 × 1.5 cm. A solid mass is present at the presumed fundus, measuring 3.0 × 2.5 × 1.5 cm (cut surface pale yellow). Another solid mass is present at the presumed neck, measuring 1.0 × 1.0 × 0.8 cm. Appendectomy specimen: Appendix measures 6.5 cm in length and 0.5 cm in diameter. HER2: 1+; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~50% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                D9
                		 39 M 60 colon Metastasis liver cancer from colon * T4aN1bM0 IIIB Metastasis Distal gastrectomy with partial hepatectomy, partial transverse colectomy, and “suspected gallbladder” specimen: The stomach measures 20 × 8 × 6 cm (lesser curvature 15 cm, greater curvature 30 cm). A raised/exophytic mass is identified 7 cm from the proximal gastric margin and adjacent to the distal gastric margin, measuring 10 × 9 × 6 cm. The cut surface is gray-white to gray-yellow and soft, with a central defect/ulceration measuring approximately 4 × 2 cm. The specimen is attached to partial liver tissue (6 × 3.5 × 1 cm) and a segment of transverse colon measuring 14 cm in length (2.5–3.0 cm in diameter). The transverse colon shows a perforation measuring 3.5 cm in diameter, located 4.5 cm from one resection margin and 6.5 cm from the opposite margin, and the perforation communicates with the tumor. A “suspected gallbladder” measures 5.5 × 2.5 × 1.5 cm. A solid mass is present at the presumed fundus, measuring 3.0 × 2.5 × 1.5 cm (cut surface pale yellow). Another solid mass is present at the presumed neck, measuring 1.0 × 1.0 × 0.8 cm. Appendectomy specimen: Appendix measures 6.5 cm in length and 0.5 cm in diameter. HER2: 1+; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~50% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                D10
                		 40 M 60 colon Cancer adjacent colon tissue * T4aN1bM0 IIIB AT Distal gastrectomy with partial hepatectomy, partial transverse colectomy, and “suspected gallbladder” specimen: The stomach measures 20 × 8 × 6 cm (lesser curvature 15 cm, greater curvature 30 cm). A raised/exophytic mass is identified 7 cm from the proximal gastric margin and adjacent to the distal gastric margin, measuring 10 × 9 × 6 cm. The cut surface is gray-white to gray-yellow and soft, with a central defect/ulceration measuring approximately 4 × 2 cm. The specimen is attached to partial liver tissue (6 × 3.5 × 1 cm) and a segment of transverse colon measuring 14 cm in length (2.5–3.0 cm in diameter). The transverse colon shows a perforation measuring 3.5 cm in diameter, located 4.5 cm from one resection margin and 6.5 cm from the opposite margin, and the perforation communicates with the tumor. A “suspected gallbladder” measures 5.5 × 2.5 × 1.5 cm. A solid mass is present at the presumed fundus, measuring 3.0 × 2.5 × 1.5 cm (cut surface pale yellow). Another solid mass is present at the presumed neck, measuring 1.0 × 1.0 × 0.8 cm. Appendectomy specimen: Appendix measures 6.5 cm in length and 0.5 cm in diameter. HER2: 1+; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100: no evidence of perineural invasion by staining. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~50% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                E1
                		 41 M 55 colon Colon cancer * T4bN0MO IIC Malignant Right hemicolectomy specimen: The ileum measures 12 cm in length (circumference 5.5 cm) and the colon measures 33 cm in length (circumference 6–10 cm). An ulcerated mass is identified 19 cm from the ileal resection margin and 22 cm from the colonic resection margin, measuring 8.0 × 5.0 cm with an estimated depth of 3.0 cm. The tumor extends into/abuts the liver and is densely adherent to adjacent bowel, with ill-defined anatomy, forming a contiguous mass measuring approximately 8.0 × 6.0 × 4.0 cm. The ileocecal region contains an appendix measuring 7.0 cm in length and 0.9 cm in diameter. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Ki-67 labeling index ~60%. Oxaliplatin + capecitabine; bevacizumab added starting with the second cycle/course. Both parents alive. Alive. *
                E2
                		 42 M 55 colon Metastasis liver cancer from colon * T4bN0MO IIC Metastasis Right hemicolectomy specimen: The ileum measures 12 cm in length (circumference 5.5 cm) and the colon measures 33 cm in length (circumference 6–10 cm). An ulcerated mass is identified 19 cm from the ileal resection margin and 22 cm from the colonic resection margin, measuring 8.0 × 5.0 cm with an estimated depth of 3.0 cm. The tumor extends into/abuts the liver and is densely adherent to adjacent bowel, with ill-defined anatomy, forming a contiguous mass measuring approximately 8.0 × 6.0 × 4.0 cm. The ileocecal region contains an appendix measuring 7.0 cm in length and 0.9 cm in diameter. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Ki-67 labeling index ~60%. Oxaliplatin + capecitabine; bevacizumab added starting with the second cycle/course. Both parents alive. Alive. *
                E3
                		 43 M 53 colon Colon cancer * T3N0M1a IVA Malignant Partial rectal resection specimen (post–chemoradiotherapy): A segment of bowel measuring 20 cm in length and 2.0–2.8 cm in diameter. An ulcerated lesion is identified 12.1 cm from one resection margin and 5.0 cm from the opposite margin, measuring 1.5 × 1.2 cm with a depth of 0.2 cm; the lesion is entirely submitted/removed. Hepatic metastatic lesion (resection/biopsy specimen): A portion of liver measuring 4.5 × 3.7 × 2.1 cm. On sectioning, a gray-white nodule measuring approximately 1.7 × 1.5 × 1.3 cm is identified, located 0.9 cm from the resection margin and involving the hepatic capsule. MLH1(+), MSH2(+), MSH6(+), PMS2(+). CDX2: positive. Ki-67 proliferation index ~30% positive. S-100: no evidence of perineural invasion by staining. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Deceased (38 months postoperatively). *
                E4
                		 44 M 53 colon Metastasis liver cancer from colon * T3N0M1a IVA Metastasis Partial rectal resection specimen (post–chemoradiotherapy): A segment of bowel measuring 20 cm in length and 2.0–2.8 cm in diameter. An ulcerated lesion is identified 12.1 cm from one resection margin and 5.0 cm from the opposite margin, measuring 1.5 × 1.2 cm with a depth of 0.2 cm; the lesion is entirely submitted/removed. Hepatic metastatic lesion (resection/biopsy specimen): A portion of liver measuring 4.5 × 3.7 × 2.1 cm. On sectioning, a gray-white nodule measuring approximately 1.7 × 1.5 × 1.3 cm is identified, located 0.9 cm from the resection margin and involving the hepatic capsule. MLH1(+), MSH2(+), MSH6(+), PMS2(+). CDX2: positive. Ki-67 proliferation index ~30% positive. S-100: no evidence of perineural invasion by staining. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Deceased (38 months postoperatively). *
                E5
                		 45 F 40 colon Colon cancer * T3N1bM0 IVA Malignant A segment of bowel measuring 30 cm in length and 2.5–3.0 cm in diameter. An ulcerated mass is identified 3.0 cm from the distal resection margin and 1.0 cm from the dentate line, measuring 4.5 × 3.0 cm, with ~1.0 cm mucosal elevation. MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. Oxaliplatin + capecitabine; bevacizumab added starting with the 3rd cycle. Liver metastasis at 11 months postoperatively; chemotherapy was adjusted to oxaliplatin + capecitabine + camrelizumab. Both parents alive. Alive; hepatic metastasis at 11 months post-op, ascites developed ~2 years post-op, with multiple recurrences. *
                E6
                		 46 F 41 colon Metastasis liver cancer from colon * TXNXM1 IVA Metastasis One irregular gray-white tissue fragment, previously incised by the surgeon, measuring 2.7 × 2.0 × 1.6 cm. * Oxaliplatin + capecitabine; bevacizumab added starting with the 3rd cycle. Liver metastasis at 11 months postoperatively; chemotherapy was adjusted to oxaliplatin + capecitabine + camrelizumab. Both parents alive. Alive; hepatic metastasis at 11 months post-op, ascites developed ~2 years post-op, with multiple recurrences. *
                E7
                		 47 F 40 colon Cancer adjacent colon tissue * T3N1bM0 IVA AT A segment of bowel measuring 30 cm in length and 2.5–3.0 cm in diameter. An ulcerated mass is identified 3.0 cm from the distal resection margin and 1.0 cm from the dentate line, measuring 4.5 × 3.0 cm, with ~1.0 cm mucosal elevation. MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. Oxaliplatin + capecitabine; bevacizumab added starting with the 3rd cycle. Liver metastasis at 11 months postoperatively; chemotherapy was adjusted to oxaliplatin + capecitabine + camrelizumab. Both parents alive. Alive; hepatic metastasis at 11 months post-op, ascites developed ~2 years post-op, with multiple recurrences. *
                E8
                		 48 M 44 colon Colon cancer * T3N0M1a IVA Malignant Partial resection of ileum and colon: The ileum measures 13 cm in length and 2.0 cm in diameter; the colon measures 15 cm in length and 3.0 cm in diameter. An ulcerated, circumferential mass is identified 6.0 cm from the colonic resection margin and approximately 7.0 cm above the ileocecal region, measuring 3.0 × 3.0 cm, with an estimated depth of 1.0 cm and ~1.0 cm mucosal elevation. The ileocecal region contains an appendix measuring 5.0 cm in length and 0.6 cm in diameter. Hepatic metastatic lesions: Four irregular liver tissue fragments measuring 3.0 × 1.5 × 1.0 cm, 3.5 × 2.0 × 1.5 cm, 5.0 × 3.5 × 3.0 cm, and 6.0 × 4.0 × 4.0 cm, respectively. MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                E9
                		 49 M 44 colon Metastasis liver cancer from colon * T3N0M1a IVA Metastasis Partial resection of ileum and colon: The ileum measures 13 cm in length and 2.0 cm in diameter; the colon measures 15 cm in length and 3.0 cm in diameter. An ulcerated, circumferential mass is identified 6.0 cm from the colonic resection margin and approximately 7.0 cm above the ileocecal region, measuring 3.0 × 3.0 cm, with an estimated depth of 1.0 cm and ~1.0 cm mucosal elevation. The ileocecal region contains an appendix measuring 5.0 cm in length and 0.6 cm in diameter. Hepatic metastatic lesions: Four irregular liver tissue fragments measuring 3.0 × 1.5 × 1.0 cm, 3.5 × 2.0 × 1.5 cm, 5.0 × 3.5 × 3.0 cm, and 6.0 × 4.0 × 4.0 cm, respectively. MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                E10
                		 50 M 44 colon Cancer adjacent colon tissue * T3N0M1a IVA AT Partial resection of ileum and colon: The ileum measures 13 cm in length and 2.0 cm in diameter; the colon measures 15 cm in length and 3.0 cm in diameter. An ulcerated, circumferential mass is identified 6.0 cm from the colonic resection margin and approximately 7.0 cm above the ileocecal region, measuring 3.0 × 3.0 cm, with an estimated depth of 1.0 cm and ~1.0 cm mucosal elevation. The ileocecal region contains an appendix measuring 5.0 cm in length and 0.6 cm in diameter. Hepatic metastatic lesions: Four irregular liver tissue fragments measuring 3.0 × 1.5 × 1.0 cm, 3.5 × 2.0 × 1.5 cm, 5.0 × 3.5 × 3.0 cm, and 6.0 × 4.0 × 4.0 cm, respectively. MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                F1
                		 51 M 67 colon Colon cancer * T4bN2bM1a IVA Malignant Right hemicolectomy specimen: The ileum measures 8.5 cm in length and 2.0 cm in diameter; the colon measures 20 cm in length and 6.0 cm in diameter. An ulcerated mass is present in the ascending colon, measuring 9.0 × 6.0 cm, with extramural extension beyond the serosa and involvement of adjacent bowel. The ileocecal region contains an appendix measuring 6.0 cm in length and 1.0 cm in diameter. Partial hepatectomy specimen: One piece of liver tissue measuring 6.0 × 3.0 × 2.0 cm; sectioning reveals a gray-white mass measuring 2.5 × 1.7 × 1.5 cm. MLH1(+), MSH2(+), MSH6(+), PMS2(+) (MMR proteins retained; pMMR). S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 proliferation index ~80%. Oxaliplatin + capecitabine + bevacizumab. Father alive; mother deceased (cause unknown). Deceased (15 months postoperatively). *
                F2
                		 52 M 67 colon Metastasis liver cancer from colon * T4bN2bM1a IVA Metastasis Right hemicolectomy specimen: The ileum measures 8.5 cm in length and 2.0 cm in diameter; the colon measures 20 cm in length and 6.0 cm in diameter. An ulcerated mass is present in the ascending colon, measuring 9.0 × 6.0 cm, with extramural extension beyond the serosa and involvement of adjacent bowel. The ileocecal region contains an appendix measuring 6.0 cm in length and 1.0 cm in diameter. Partial hepatectomy specimen: One piece of liver tissue measuring 6.0 × 3.0 × 2.0 cm; sectioning reveals a gray-white mass measuring 2.5 × 1.7 × 1.5 cm. MLH1(+), MSH2(+), MSH6(+), PMS2(+) (MMR proteins retained; pMMR). S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 proliferation index ~80%. Oxaliplatin + capecitabine + bevacizumab. Father alive; mother deceased (cause unknown). Deceased (15 months postoperatively). *
                F3
                		 53 M 64 colon Colon cancer * T4bN1aM1a IVA Malignant 1. Mesenteric root mass: One irregular tissue fragment measuring approximately 6.0 × 4.0 × 2.5 cm; cut surface gray-red, friable (“fish-flesh–like”), soft. 2. Small-bowel mesenteric nodule: One irregular gray-yellow tissue fragment measuring 0.9 × 0.8 × 0.2 cm; a focal firm gray-white nodule is present, measuring approximately 0.2 × 0.2 cm. 3. Liver nodule: One irregular gray-red tissue fragment measuring 3.5 × 1.8 × 1.5 cm; cut surface gray-red, friable (“fish-flesh–like”), soft. 4. Perirenal fat capsule: One irregular gray-yellow tissue fragment measuring approximately 3.0 × 3.0 × 1.0 cm, focally firm. 5. Right hemicolectomy specimen: The ileum measures 57 cm in length and 2.0 cm in diameter, with no gross mucosal abnormality. The colon measures 22 cm in length (diameter not specified). A large mass is present in the ileocecal region, measuring approximately 10.0 × 8.0 × 4.5 cm. The ileocecal region contains an appendix measuring 4.0 cm in length and 0.8 cm in diameter. MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 proliferation index ~85%. CD56: negative; Chromogranin A (CgA): negative; Synaptophysin: negative. CK8/18: positive. Oxaliplatin + capecitabine; bevacizumab added starting with the 6th chemotherapy cycle. Both parents alive. Ascites developed 6 months postoperatively; deceased at 13 months postoperatively. *
                F4
                		 54 M 64 colon Metastasis liver cancer from colon * T4bN1aM1a IVA Metastasis 1. Mesenteric root mass: One irregular tissue fragment measuring approximately 6.0 × 4.0 × 2.5 cm; cut surface gray-red, friable (“fish-flesh–like”), soft. 2. Small-bowel mesenteric nodule: One irregular gray-yellow tissue fragment measuring 0.9 × 0.8 × 0.2 cm; a focal firm gray-white nodule is present, measuring approximately 0.2 × 0.2 cm. 3. Liver nodule: One irregular gray-red tissue fragment measuring 3.5 × 1.8 × 1.5 cm; cut surface gray-red, friable (“fish-flesh–like”), soft. 4. Perirenal fat capsule: One irregular gray-yellow tissue fragment measuring approximately 3.0 × 3.0 × 1.0 cm, focally firm. 5. Right hemicolectomy specimen: The ileum measures 57 cm in length and 2.0 cm in diameter, with no gross mucosal abnormality. The colon measures 22 cm in length (diameter not specified). A large mass is present in the ileocecal region, measuring approximately 10.0 × 8.0 × 4.5 cm. The ileocecal region contains an appendix measuring 4.0 cm in length and 0.8 cm in diameter. MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 proliferation index ~85%. CD56: negative; Chromogranin A (CgA): negative; Synaptophysin: negative. CK8/18: positive. Oxaliplatin + capecitabine; bevacizumab added starting with the 6th chemotherapy cycle. Both parents alive. Ascites developed 6 months postoperatively; deceased at 13 months postoperatively. *
                F5
                		 55 F 55 colon Colon cancer * T3N1bM1b IVB Malignant 1.Sigmoid colectomy specimen: A segment of bowel measuring 11 cm in length and 2–3 cm in diameter. A metallic stent/mesh is present within the lumen. An ulcerated mass is identified 3.5 cm from one resection margin and 4.0 cm from the opposite margin, measuring 3.0 × 3.0 × 1.5 cm; the surface is gray-red and is firmly adherent to the metallic stent/mesh. 2.Total hysterectomy specimen: Uterus measuring 8.0 × 6.0 × 4.5 cm. Cervix length 3.0 cm; external os 4.0 cm in diameter; internal os 2.0 cm in diameter. The uterus is opened along the anterior wall; myometrium 2.5 cm thick and endometrium 0.1 cm thick. Multiple intramural nodules are present (0.5–1.0 cm), with gray-white, whorled, firm cut surfaces; dark-brown hemorrhage is noted within the myometrium. 3.Bilateral salpingo-oophorectomy specimens: 4.Right adnexa: Right fallopian tube 5.0 cm long (0.5–0.7 cm in diameter). Right ovary 5.0 × 4.0 × 1.0 cm with multiple cystic lesions (1.5–4.5 cm), dark-brown; on sectioning, coffee-colored fluid is expressed; cyst wall thickness 0.2–0.3 cm. 5.Left adnexa: Left fallopian tube 4.5 cm long (0.5–0.7 cm in diameter). Left ovary 3.0 × 2.5 × 1.5 cm with a large cyst measuring 8.0 × 6.0 × 3.5 cm; cyst contents are lost; wall thickness 0.2–0.5 cm; inner surface coarse and firm. 6.Liver tissue: One irregular piece of liver measuring 4.0 × 3.5 × 3.0 cm; the cut surface is dark-brown with a gray-white nodule (size as provided). HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Ki-67 labeling index ~85% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. *
                F6
                		 56 F 55 colon Metastasis liver cancer from colon * T3N1bM1b IVB Metastasis 1.Sigmoid colectomy specimen: A segment of bowel measuring 11 cm in length and 2–3 cm in diameter. A metallic stent/mesh is present within the lumen. An ulcerated mass is identified 3.5 cm from one resection margin and 4.0 cm from the opposite margin, measuring 3.0 × 3.0 × 1.5 cm; the surface is gray-red and is firmly adherent to the metallic stent/mesh. 2.Total hysterectomy specimen: Uterus measuring 8.0 × 6.0 × 4.5 cm. Cervix length 3.0 cm; external os 4.0 cm in diameter; internal os 2.0 cm in diameter. The uterus is opened along the anterior wall; myometrium 2.5 cm thick and endometrium 0.1 cm thick. Multiple intramural nodules are present (0.5–1.0 cm), with gray-white, whorled, firm cut surfaces; dark-brown hemorrhage is noted within the myometrium. 3.Bilateral salpingo-oophorectomy specimens: 4.Right adnexa: Right fallopian tube 5.0 cm long (0.5–0.7 cm in diameter). Right ovary 5.0 × 4.0 × 1.0 cm with multiple cystic lesions (1.5–4.5 cm), dark-brown; on sectioning, coffee-colored fluid is expressed; cyst wall thickness 0.2–0.3 cm. 5.Left adnexa: Left fallopian tube 4.5 cm long (0.5–0.7 cm in diameter). Left ovary 3.0 × 2.5 × 1.5 cm with a large cyst measuring 8.0 × 6.0 × 3.5 cm; cyst contents are lost; wall thickness 0.2–0.5 cm; inner surface coarse and firm. 6.Liver tissue: One irregular piece of liver measuring 4.0 × 3.5 × 3.0 cm; the cut surface is dark-brown with a gray-white nodule (size as provided). HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Ki-67 labeling index ~85% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. *
                F7
                		 57 F 55 colon Cancer adjacent colon tissue * T3N1bM1b IVB AT 1.Sigmoid colectomy specimen: A segment of bowel measuring 11 cm in length and 2–3 cm in diameter. A metallic stent/mesh is present within the lumen. An ulcerated mass is identified 3.5 cm from one resection margin and 4.0 cm from the opposite margin, measuring 3.0 × 3.0 × 1.5 cm; the surface is gray-red and is firmly adherent to the metallic stent/mesh. 2.Total hysterectomy specimen: Uterus measuring 8.0 × 6.0 × 4.5 cm. Cervix length 3.0 cm; external os 4.0 cm in diameter; internal os 2.0 cm in diameter. The uterus is opened along the anterior wall; myometrium 2.5 cm thick and endometrium 0.1 cm thick. Multiple intramural nodules are present (0.5–1.0 cm), with gray-white, whorled, firm cut surfaces; dark-brown hemorrhage is noted within the myometrium. 3.Bilateral salpingo-oophorectomy specimens: 4.Right adnexa: Right fallopian tube 5.0 cm long (0.5–0.7 cm in diameter). Right ovary 5.0 × 4.0 × 1.0 cm with multiple cystic lesions (1.5–4.5 cm), dark-brown; on sectioning, coffee-colored fluid is expressed; cyst wall thickness 0.2–0.3 cm. 5.Left adnexa: Left fallopian tube 4.5 cm long (0.5–0.7 cm in diameter). Left ovary 3.0 × 2.5 × 1.5 cm with a large cyst measuring 8.0 × 6.0 × 3.5 cm; cyst contents are lost; wall thickness 0.2–0.5 cm; inner surface coarse and firm. 6.Liver tissue: One irregular piece of liver measuring 4.0 × 3.5 × 3.0 cm; the cut surface is dark-brown with a gray-white nodule (size as provided). HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40: no evidence of lymphovascular invasion by staining. Ki-67 labeling index ~85% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. *
                F8
                		 58 M 79 colon Colon cancer * T3N0M1a IVA Malignant A partial hepatectomy specimen measuring 9.0 × 8.0 × 5.0 cm. Sectioning reveals a gray-yellow mass measuring 6.5 × 5.0 cm, poorly circumscribed with ill-defined interface with the surrounding hepatic parenchyma; cut surface is solid. A right hemicolectomy specimen with a segment of terminal ileum: colon length 25 cm, ileum length 15 cm. An appendix is present at the ileocecal region, measuring 4.0 cm in length and 0.5 cm in diameter. An ulceroinfiltrative lesion is identified 4.0 cm from the ileocecal valve and 20.0 cm from the colonic resection margin, measuring 4.0 × 3.0 cm, with an estimated depth of 1.5 cm and an exophytic elevation of approximately 1.5 cm. * Oxaliplatin + capecitabine. Both parents deceased; cause unknown. Deceased (12 months postoperatively). *
                F9
                		 59 M 79 colon Metastasis liver cancer from colon * T3N0M1a IVA Metastasis A partial hepatectomy specimen measuring 9.0 × 8.0 × 5.0 cm. Sectioning reveals a gray-yellow mass measuring 6.5 × 5.0 cm, poorly circumscribed with ill-defined interface with the surrounding hepatic parenchyma; cut surface is solid. A right hemicolectomy specimen with a segment of terminal ileum: colon length 25 cm, ileum length 15 cm. An appendix is present at the ileocecal region, measuring 4.0 cm in length and 0.5 cm in diameter. An ulceroinfiltrative lesion is identified 4.0 cm from the ileocecal valve and 20.0 cm from the colonic resection margin, measuring 4.0 × 3.0 cm, with an estimated depth of 1.5 cm and an exophytic elevation of approximately 1.5 cm. * Oxaliplatin + capecitabine. Both parents deceased; cause unknown. Deceased (12 months postoperatively). *
                F10
                		 60 M 79 colon Cancer adjacent colon tissue * T3N0M1a IVA AT A partial hepatectomy specimen measuring 9.0 × 8.0 × 5.0 cm. Sectioning reveals a gray-yellow mass measuring 6.5 × 5.0 cm, poorly circumscribed with ill-defined interface with the surrounding hepatic parenchyma; cut surface is solid. A right hemicolectomy specimen with a segment of terminal ileum: colon length 25 cm, ileum length 15 cm. An appendix is present at the ileocecal region, measuring 4.0 cm in length and 0.5 cm in diameter. An ulceroinfiltrative lesion is identified 4.0 cm from the ileocecal valve and 20.0 cm from the colonic resection margin, measuring 4.0 × 3.0 cm, with an estimated depth of 1.5 cm and an exophytic elevation of approximately 1.5 cm. * Oxaliplatin + capecitabine. Both parents deceased; cause unknown. Deceased (12 months postoperatively). *
                G1
                		 61 M 67 colon Colon cancer * T2N0M1a IVA Malignant 1.Descending colectomy specimen: A segment of bowel measuring 14.5 cm in length with a circumference of 3.0–7.8 cm. A polypoid protrusion is identified 7.5 cm from one resection margin, measuring 0.5 × 0.5 × 0.3 cm. An ulcerated, stenotic/contracted area is identified 8.7 cm from one resection margin and 5.0 cm from the opposite margin, measuring 3.0 × 0.7 cm. Near one resection margin, the mucosal folds are effaced; the mucosa is smooth and glistening. 2.Cholecystectomy specimen: One gallbladder measuring 9.5 × 4.0 × 3.0 cm. The mucosa is slightly roughened; the wall thickness is 0.1 cm. The lumen contains dark green bile and four gallstones. 3.Liver tissue: Two irregular liver fragments. The smaller measures 5.0 × 2.0 × 2.0 cm with a firm gray-white area measuring 0.6 × 0.5 cm on the surface; the cut surface is gray-white to yellow-gray. The larger measures 7.0 × 4.5 × 2.5 cm, with a surface ligation site; a gray-white surface area measuring 0.5 × 0.6 cm is present. On cut section, a gray-white to gray-yellow area measuring 1.2 × 1.4 cm is identified with a slightly tough texture; an adjacent previously incised gray-white area measuring 0.2 × 0.2 × 0.5 cm is also noted. Colon tumor: HER2: 2+; CDX2: positive; Ki-67 ~40%. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. CD34 and D2-40 highlight vascular/lymphatic structures (supporting lymphovascular invasion as reported). Liver tumor: AE1/AE3(+), SATB2(+), CK19(+), CK7(-) (profile supportive of colorectal primary in this context). Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. *
                G2
                		 62 M 67 colon Metastasis liver cancer from colon * T2N0M1a IVA Metastasis 1.Descending colectomy specimen: A segment of bowel measuring 14.5 cm in length with a circumference of 3.0–7.8 cm. A polypoid protrusion is identified 7.5 cm from one resection margin, measuring 0.5 × 0.5 × 0.3 cm. An ulcerated, stenotic/contracted area is identified 8.7 cm from one resection margin and 5.0 cm from the opposite margin, measuring 3.0 × 0.7 cm. Near one resection margin, the mucosal folds are effaced; the mucosa is smooth and glistening. 2.Cholecystectomy specimen: One gallbladder measuring 9.5 × 4.0 × 3.0 cm. The mucosa is slightly roughened; the wall thickness is 0.1 cm. The lumen contains dark green bile and four gallstones. 3.Liver tissue: Two irregular liver fragments. The smaller measures 5.0 × 2.0 × 2.0 cm with a firm gray-white area measuring 0.6 × 0.5 cm on the surface; the cut surface is gray-white to yellow-gray. The larger measures 7.0 × 4.5 × 2.5 cm, with a surface ligation site; a gray-white surface area measuring 0.5 × 0.6 cm is present. On cut section, a gray-white to gray-yellow area measuring 1.2 × 1.4 cm is identified with a slightly tough texture; an adjacent previously incised gray-white area measuring 0.2 × 0.2 × 0.5 cm is also noted. Colon tumor: HER2: 2+; CDX2: positive; Ki-67 ~40%. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. CD34 and D2-40 highlight vascular/lymphatic structures (supporting lymphovascular invasion as reported). Liver tumor: AE1/AE3(+), SATB2(+), CK19(+), CK7(-) (profile supportive of colorectal primary in this context). Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. *
                G3
                		 63 F 45 colon Colon cancer * T3N2aM1a IVA Malignant Rectal resection specimen: A segment of bowel measuring 9.5 cm in length and 2.5–3.0 cm in diameter. An ulcerated lesion/mass is identified 4.2 cm from one resection margin and 3.0 cm from the opposite margin, measuring 2.3 × 2.0 cm; the tumor is entirely submitted/removed. Additional specimen submitted: (Hepatic metastatic carcinoma) One dark gray, irregular soft tissue fragment measuring 1.3 × 1.0 × 0.2 cm. MLH1(+), MSH2(+), MSH6(+), PMS2(+). HER2: 0; CDX2: positive. S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. *
                G4
                		 64 F 45 colon Metastasis liver cancer from colon * T3N2aM1a IVA Metastasis Rectal resection specimen: A segment of bowel measuring 9.5 cm in length and 2.5–3.0 cm in diameter. An ulcerated lesion/mass is identified 4.2 cm from one resection margin and 3.0 cm from the opposite margin, measuring 2.3 × 2.0 cm; the tumor is entirely submitted/removed. Additional specimen submitted: (Hepatic metastatic carcinoma) One dark gray, irregular soft tissue fragment measuring 1.3 × 1.0 × 0.2 cm. MLH1(+), MSH2(+), MSH6(+), PMS2(+). HER2: 0; CDX2: positive. S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~80% positive. Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. *
                G5
                		 65 M 56 colon Colon cancer * T3N1aM1a IVA Malignant Sigmoid colectomy specimen: A segment of bowel measuring 13 cm in length and 3.5 cm in diameter. An ulcerated lesion/mass is identified 4.0 cm from the proximal resection margin and 7.0 cm from the distal resection margin, measuring 2.0 × 1.5 cm; the tumor is entirely submitted/removed. Partial liver tissue: One piece of liver tissue measuring 3.5 × 2.1 × 2.5 cm; on cut section, a gray-white area measuring 2.0 × 1.0 cm is identified. Ki-67 labeling index ~70% positive; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. D2-40 and CD34: no definite lymphovascular invasion by staining. Oxaliplatin + capecitabine. Both parents alive. Alive. KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                G6
                		 66 M 56 colon Metastasis liver cancer from colon * T3N1aM1a IVA Metastasis Sigmoid colectomy specimen: A segment of bowel measuring 13 cm in length and 3.5 cm in diameter. An ulcerated lesion/mass is identified 4.0 cm from the proximal resection margin and 7.0 cm from the distal resection margin, measuring 2.0 × 1.5 cm; the tumor is entirely submitted/removed. Partial liver tissue: One piece of liver tissue measuring 3.5 × 2.1 × 2.5 cm; on cut section, a gray-white area measuring 2.0 × 1.0 cm is identified. Ki-67 labeling index ~70% positive; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. D2-40 and CD34: no definite lymphovascular invasion by staining. Oxaliplatin + capecitabine. Both parents alive. Alive. KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                G7
                		 67 M 56 colon Cancer adjacent colon tissue * T3N1aM1a IVA AT Sigmoid colectomy specimen: A segment of bowel measuring 13 cm in length and 3.5 cm in diameter. An ulcerated lesion/mass is identified 4.0 cm from the proximal resection margin and 7.0 cm from the distal resection margin, measuring 2.0 × 1.5 cm; the tumor is entirely submitted/removed. Partial liver tissue: One piece of liver tissue measuring 3.5 × 2.1 × 2.5 cm; on cut section, a gray-white area measuring 2.0 × 1.0 cm is identified. Ki-67 labeling index ~70% positive; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 supports perineural invasion. D2-40 and CD34: no definite lymphovascular invasion by staining. Oxaliplatin + capecitabine. Both parents alive. Alive. KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                G8
                		 68 F 37 colon Colon cancer * T3N1bM1a IVA Malignant 1.Abdominoperineal resection (rectum with anus): A segment of bowel measuring 16 cm in length and 3.0 cm in diameter. An ulcerated lesion/mass is identified 4.0 cm from the distal (anal) margin and 9.0 cm from the proximal margin, measuring 2.5 × 2.0 cm; the tumor is entirely submitted/removed. 2.Cholecystectomy with segment V liver tumor resection: One gallbladder measuring 8.5 × 3.0 × 3.0 cm. The mucosa is coarse/roughened; wall thickness 0.2 cm; the lumen contains dark green bile. An attached liver specimen measures 4.0 × 4.0 × 3.5 cm and is adherent to the gallbladder. HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~60% positive. Oxaliplatin + capecitabine; immunotherapy added after the 2nd cycle (oxaliplatin + capecitabine + camrelizumab). Both parents alive. Alive. *
                G9
                		 69 F 37 colon Metastasis liver cancer from colon * T3N1bM1a IVA Metastasis 1.Abdominoperineal resection (rectum with anus): A segment of bowel measuring 16 cm in length and 3.0 cm in diameter. An ulcerated lesion/mass is identified 4.0 cm from the distal (anal) margin and 9.0 cm from the proximal margin, measuring 2.5 × 2.0 cm; the tumor is entirely submitted/removed. 2.Cholecystectomy with segment V liver tumor resection: One gallbladder measuring 8.5 × 3.0 × 3.0 cm. The mucosa is coarse/roughened; wall thickness 0.2 cm; the lumen contains dark green bile. An attached liver specimen measures 4.0 × 4.0 × 3.5 cm and is adherent to the gallbladder. HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~60% positive. Oxaliplatin + capecitabine; immunotherapy added after the 2nd cycle (oxaliplatin + capecitabine + camrelizumab). Both parents alive. Alive. *
                G10
                		 70 F 37 colon Cancer adjacent colon tissue * T3N1bM1a IVA AT 1.Abdominoperineal resection (rectum with anus): A segment of bowel measuring 16 cm in length and 3.0 cm in diameter. An ulcerated lesion/mass is identified 4.0 cm from the distal (anal) margin and 9.0 cm from the proximal margin, measuring 2.5 × 2.0 cm; the tumor is entirely submitted/removed. 2.Cholecystectomy with segment V liver tumor resection: One gallbladder measuring 8.5 × 3.0 × 3.0 cm. The mucosa is coarse/roughened; wall thickness 0.2 cm; the lumen contains dark green bile. An attached liver specimen measures 4.0 × 4.0 × 3.5 cm and is adherent to the gallbladder. HER2: 0; CDX2: positive. MMR proteins retained (pMMR): MLH1(+), MSH2(+), MSH6(+), PMS2(+). S-100 highlights perineural invasion. CD34 and D2-40 highlight lymphovascular invasion. Ki-67 labeling index ~60% positive. Oxaliplatin + capecitabine; immunotherapy added after the 2nd cycle (oxaliplatin + capecitabine + camrelizumab). Both parents alive. Alive. *
                H1
                		 71 F 48 colon Colon cancer * T4aN1aM0 IIIB Malignant Mesenteric root lymph node: A small aggregate of adipose tissue measuring 1.0 × 0.8 × 0.2 cm. Right hemicolectomy specimen: A segment of right colon measuring 30 cm in length and 2.5–5.5 cm in diameter, with an attached appendix measuring 5.0 cm in length and 0.6 cm in diameter; the serosa is congested. The bowel is opened along the antimesenteric border. An ulcerated, exophytic mass is identified 9 cm from one colonic end and 15 cm from the ileocecal region, measuring 5.0 × 7.0 × 2.0 cm. MLH1(+),MSH2(+),MSH6(+),PMS2(+),Ki-67(70%+),P53(+),CD34(-),S-100(-). Oxaliplatin + capecitabine; targeted therapy (bevacizumab) added after the 2nd cycle (oxaliplatin + capecitabine + bevacizumab). Both parents alive. Alive. *
                H2
                		 72 F 48 Lymph node Metastatic cancer from colon * T4aN1aM0 IIIB Metastasis Mesenteric root lymph node: A small aggregate of adipose tissue measuring 1.0 × 0.8 × 0.2 cm. Right hemicolectomy specimen: A segment of right colon measuring 30 cm in length and 2.5–5.5 cm in diameter, with an attached appendix measuring 5.0 cm in length and 0.6 cm in diameter; the serosa is congested. The bowel is opened along the antimesenteric border. An ulcerated, exophytic mass is identified 9 cm from one colonic end and 15 cm from the ileocecal region, measuring 5.0 × 7.0 × 2.0 cm. MLH1(+),MSH2(+),MSH6(+),PMS2(+),Ki-67(70%+),P53(+),CD34(-),S-100(-). Oxaliplatin + capecitabine; targeted therapy (bevacizumab) added after the 2nd cycle (oxaliplatin + capecitabine + bevacizumab). Both parents alive. Alive. *
                H3
                		 73 F 83 colon Colon cancer * T3N1bM0 IIIB Malignant Resection margin specimen: One tubular tissue fragment measuring 0.8 cm in length and 2.5 cm in diameter. Colon resection specimen: A segment of bowel, previously opened by the surgeon, measuring 15.5 cm in length and 4.0 cm in diameter. A raised/exophytic mass is identified 2.0 cm from one resection margin and 9.5 cm from the opposite margin, measuring 4.4 × 3.5 × 3.0 cm. CD34(-),CK20(+),CK7(-),Ki-67(80%),P53(++),S-100(-),MSH6(++),MSH2(++),MLH1(++),PMS2(++) Oxaliplatin + capecitabine for two cycles; poor tolerance reported. Both parents deceased; cause unknown. Deceased (18 months postoperatively). *
                H4
                		 74 F 83 Lymph node Metastatic cancer from colon * T3N1bM0 IIIB Metastasis Resection margin specimen: One tubular tissue fragment measuring 0.8 cm in length and 2.5 cm in diameter. Colon resection specimen: A segment of bowel, previously opened by the surgeon, measuring 15.5 cm in length and 4.0 cm in diameter. A raised/exophytic mass is identified 2.0 cm from one resection margin and 9.5 cm from the opposite margin, measuring 4.4 × 3.5 × 3.0 cm. CD34(-),CK20(+),CK7(-),Ki-67(80%),P53(++),S-100(-),MSH6(++),MSH2(++),MLH1(++),PMS2(++) Oxaliplatin + capecitabine for two cycles; poor tolerance reported. Both parents deceased; cause unknown. Deceased (18 months postoperatively). *
                H5
                		 75 F 65 colon Colon cancer * T4aN2aM0 IIIC Malignant 1.Annular tissue fragment: One ring-shaped tissue fragment measuring 5.0 cm in length and 3.5 cm in diameter. 2.Mucosal tissue fragment: One mucosal tissue fragment measuring 2.0 × 1.5 × 0.6 cm. 3.Appendix: One appendix measuring 3.5 cm in length and 0.8–1.2 cm in diameter; the lumen contains fecal material; no perforation identified. 4.Sigmoid colectomy specimen: A segment of sigmoid colon measuring 11 cm in length and 4.0 cm in diameter. The bowel is opened along the mesenteric border. A circumferential, gray-white, annular exophytic mass is identified 7.0 cm from one resection margin and 8.0 cm from the opposite margin, measuring 7.5 × 3.8 × 2.0 cm. Grossly, the tumor extends to the serosal surface. The cut surface is gray-white and firm, poorly demarcated from the surrounding tissue. The remaining bowel shows no remarkable gross change. CKpan(+),CK7(-),CK20(+),CEA(+),Ki-67(60%+),P53(+),MLH1(+),MSH2(+),MSH6(+),PMS2(+),s-100(-),CD31(-),D2-40(+). Oxaliplatin + capecitabine; bevacizumab added starting with the 6th chemotherapy cycle. Both parents alive. Alive. *
                H6
                		 76 F 65 Lymph node Metastatic cancer from colon * T4aN2aM0 IIIC Metastasis 1.Annular tissue fragment: One ring-shaped tissue fragment measuring 5.0 cm in length and 3.5 cm in diameter. 2.Mucosal tissue fragment: One mucosal tissue fragment measuring 2.0 × 1.5 × 0.6 cm. 3.Appendix: One appendix measuring 3.5 cm in length and 0.8–1.2 cm in diameter; the lumen contains fecal material; no perforation identified. 4.Sigmoid colectomy specimen: A segment of sigmoid colon measuring 11 cm in length and 4.0 cm in diameter. The bowel is opened along the mesenteric border. A circumferential, gray-white, annular exophytic mass is identified 7.0 cm from one resection margin and 8.0 cm from the opposite margin, measuring 7.5 × 3.8 × 2.0 cm. Grossly, the tumor extends to the serosal surface. The cut surface is gray-white and firm, poorly demarcated from the surrounding tissue. The remaining bowel shows no remarkable gross change. CKpan(+),CK7(-),CK20(+),CEA(+),Ki-67(60%+),P53(+),MLH1(+),MSH2(+),MSH6(+),PMS2(+),s-100(-),CD31(-),D2-40(+). Oxaliplatin + capecitabine; bevacizumab added starting with the 6th chemotherapy cycle. Both parents alive. Alive. *
                H7
                		 77 F 40 colon Colon cancer * T3N1bM0 IIIB Malignant Appendix: One gray-white appendix measuring 6.0 cm in length and 0.4–0.6 cm in diameter. The serosal surface is relatively smooth and covered by adipose tissue. Sigmoid colectomy specimen: A segment of sigmoid colon measuring 9.5 cm in length and 2.0–4.0 cm in diameter. The bowel is opened along the antimesenteric border. An ulcerated mass is identified on the mesenteric side, located 5.0 cm from one resection margin and 3.5 cm from the opposite margin, measuring 3.0 × 2.5 × 2.5 cm. Grossly, the tumor extends into the serosal/pericolonic adipose tissue. (sigmoid colon)-3CK7(-),CK20(+),CEA(+),CD31(-),D2-40(-),Ki-67(60%+),P53,MSH2(+),MSH6(+),MLH1(+),PMS2(+),S-100(+). -12 CKpan(-). Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. KRAS mutation present. NRAS mutation present. BRAF V600E: no mutation detected.
                H8
                		 78 F 40 Lymph node Metastatic cancer from colon * T3N1bM0 IIIB Metastasis Appendix: One gray-white appendix measuring 6.0 cm in length and 0.4–0.6 cm in diameter. The serosal surface is relatively smooth and covered by adipose tissue. Sigmoid colectomy specimen: A segment of sigmoid colon measuring 9.5 cm in length and 2.0–4.0 cm in diameter. The bowel is opened along the antimesenteric border. An ulcerated mass is identified on the mesenteric side, located 5.0 cm from one resection margin and 3.5 cm from the opposite margin, measuring 3.0 × 2.5 × 2.5 cm. Grossly, the tumor extends into the serosal/pericolonic adipose tissue. (sigmoid colon)-3CK7(-),CK20(+),CEA(+),CD31(-),D2-40(-),Ki-67(60%+),P53,MSH2(+),MSH6(+),MLH1(+),PMS2(+),S-100(+). -12 CKpan(-). Oxaliplatin + capecitabine + bevacizumab. Both parents alive. Alive. KRAS mutation present. NRAS mutation present. BRAF V600E: no mutation detected.
                H9
                		 79 F 52 colon Colon cancer * T3N2aM0 IIIB Malignant Total colectomy with rectum and appendix: A continuous bowel segment measuring 89 cm in length with a circumference of 5.0–10.3 cm, with an attached appendix measuring 6.5 cm in length and 0.7 cm in diameter. The specimen is opened along the antimesenteric border. Throughout the colon and rectum, the mucosa contains hundreds of gray-white to gray-red polyps of variable size (0.2–1.8 cm in diameter), a minority of which are pedunculated. An ulcerated mass is identified 14 cm from the proximal margin, measuring 4.5 × 2.0 cm with a depth of 1.3 cm; grossly, it extends into the pericolic adipose tissue, and the ulcerated area is adherent to surrounding fat. More than 90 pericolic lymph nodes are identified in the mesenteric fat, measuring 0.2–1.0 cm. CEA(+),CK7(-),CK20(+),Her-2(0+),Ki-67(60%+),P53(+),PMS2(+),MLH1(+)MSH2(+),MSH6(+). Oxaliplatin + capecitabine. Father alive; mother deceased (accidental). Alive. *
                H10
                		 80 F 52 Lymph node Metastatic cancer from colon * T3N2aM0 IIIB Metastasis Total colectomy with rectum and appendix: A continuous bowel segment measuring 89 cm in length with a circumference of 5.0–10.3 cm, with an attached appendix measuring 6.5 cm in length and 0.7 cm in diameter. The specimen is opened along the antimesenteric border. Throughout the colon and rectum, the mucosa contains hundreds of gray-white to gray-red polyps of variable size (0.2–1.8 cm in diameter), a minority of which are pedunculated. An ulcerated mass is identified 14 cm from the proximal margin, measuring 4.5 × 2.0 cm with a depth of 1.3 cm; grossly, it extends into the pericolic adipose tissue, and the ulcerated area is adherent to surrounding fat. More than 90 pericolic lymph nodes are identified in the mesenteric fat, measuring 0.2–1.0 cm. CEA(+),CK7(-),CK20(+),Her-2(0+),Ki-67(60%+),P53(+),PMS2(+),MLH1(+)MSH2(+),MSH6(+). Oxaliplatin + capecitabine. Father alive; mother deceased (accidental). Alive. *
                I1
                		 81 F 59 colon Colon cancer * T4aN1aM0 IIIB Malignant Appendix: One appendix measuring 7.0 cm in length and 0.5–1.0 cm in diameter; the lumen contains fecal material. Fatty tissue (mesenteric/pericolic fat): One aggregate of gray-brown adipose-like tissue measuring 5.0 × 3.5 × 0.9 cm. Sigmoid colectomy specimen: A segment of sigmoid colon, previously opened by the surgeon, measuring 15 cm in length and 3.5–4.0 cm in diameter. A polypoid lesion is identified 2.0 cm from one resection margin and 12.5 cm from the opposite margin, measuring 1.2 × 1.0 cm and protruding 0.7 cm above the mucosal surface. An ulceroinfiltrative/exophytic mass is identified 5.0 cm from one resection margin and 7.5 cm from the opposite margin; the ulcer measures 5.0 × 4.5 cm with a depth of 0.7 cm and protrudes 0.5 cm above the mucosal surface; the lesion extends into the extramural/pericolonic adipose tissue. P53(+),Ki-67(70%+),S-100(-),D2-40(-),CD31(-),MLH1(+),MSH2(+),MSH6(+),PMS2(+). Oxaliplatin + capecitabine; regimen changed at the 4th cycle to oxaliplatin + 5-fluorouracil (5-FU). Both parents alive. Alive. *
                I2
                		 82 F 59 Lymph node Metastatic cancer from colon * T4aN1aM0 IIIB Metastasis Appendix: One appendix measuring 7.0 cm in length and 0.5–1.0 cm in diameter; the lumen contains fecal material. Fatty tissue (mesenteric/pericolic fat): One aggregate of gray-brown adipose-like tissue measuring 5.0 × 3.5 × 0.9 cm. Sigmoid colectomy specimen: A segment of sigmoid colon, previously opened by the surgeon, measuring 15 cm in length and 3.5–4.0 cm in diameter. A polypoid lesion is identified 2.0 cm from one resection margin and 12.5 cm from the opposite margin, measuring 1.2 × 1.0 cm and protruding 0.7 cm above the mucosal surface. An ulceroinfiltrative/exophytic mass is identified 5.0 cm from one resection margin and 7.5 cm from the opposite margin; the ulcer measures 5.0 × 4.5 cm with a depth of 0.7 cm and protrudes 0.5 cm above the mucosal surface; the lesion extends into the extramural/pericolonic adipose tissue. P53(+),Ki-67(70%+),S-100(-),D2-40(-),CD31(-),MLH1(+),MSH2(+),MSH6(+),PMS2(+). Oxaliplatin + capecitabine; regimen changed at the 4th cycle to oxaliplatin + 5-fluorouracil (5-FU). Both parents alive. Alive. *
                I3
                		 83 F 56 colon Colon cancer * T3N2aM0 IIIB Malignant Appendix: One appendix measuring 4.85 cm in length and 0.5 cm in diameter; the lumen contains fecal material; the serosa is congested/hyperemic. Sigmoid colectomy specimen: A segment of sigmoid colon measuring 17 cm in length and 5.0–5.6 cm in diameter. On opening, a circumferential exophytic mass is identified 6.0 cm from one resection margin and 4.0 cm from the opposite margin, measuring 5.0 × 8.0 cm; grossly, the tumor appears transmural. Ki-67(80%+),P53(-),S-100(-),MSH2(++),MSH6(++),PMS2(++),MLH1(++). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                I4
                		 84 F 56 Lymph node Metastatic cancer from colon * T3N2aM0 IIIB Metastasis Appendix: One appendix measuring 4.85 cm in length and 0.5 cm in diameter; the lumen contains fecal material; the serosa is congested/hyperemic. Sigmoid colectomy specimen: A segment of sigmoid colon measuring 17 cm in length and 5.0–5.6 cm in diameter. On opening, a circumferential exophytic mass is identified 6.0 cm from one resection margin and 4.0 cm from the opposite margin, measuring 5.0 × 8.0 cm; grossly, the tumor appears transmural. Ki-67(80%+),P53(-),S-100(-),MSH2(++),MSH6(++),PMS2(++),MLH1(++). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                I5
                		 85 F 65 colon Colon cancer * T3N2aM0 IIIB Malignant A segment of colon measuring 11 cm in length and 2.5–3.0 cm in diameter. An ulcerofungating (ulcerated, exophytic) mass is identified 3.5 cm from one resection margin and 2.5 cm from the opposite margin, measuring 4.0 × 3.5 cm with an ulcer depth of 1.0 cm. TopoII(+),TS(++),PGP(+),MRP(+),MLH1(++),MSH2(++),MSH6(++),PMS2(++),Her-2(-). Oxaliplatin + capecitabine; bevacizumab added starting with the 8th cycle. Both parents alive. Ascites developed 7 months postoperatively; deceased at 26 months postoperatively. *
                I6
                		 86 F 65 Lymph node Metastatic cancer from colon * T3N2aM0 IIIB Metastasis A segment of colon measuring 11 cm in length and 2.5–3.0 cm in diameter. An ulcerofungating (ulcerated, exophytic) mass is identified 3.5 cm from one resection margin and 2.5 cm from the opposite margin, measuring 4.0 × 3.5 cm with an ulcer depth of 1.0 cm. TopoII(+),TS(++),PGP(+),MRP(+),MLH1(++),MSH2(++),MSH6(++),PMS2(++),Her-2(-). Oxaliplatin + capecitabine; bevacizumab added starting with the 8th cycle. Both parents alive. Ascites developed 7 months postoperatively; deceased at 26 months postoperatively. *
                I7
                		 87 F 67 colon Colon cancer * T3N1aM0 IIIB Malignant Right hemicolectomy (ileocecal segment): The specimen includes 8 cm of ileum (3.0 cm in diameter) and 25.5 cm of colon (3.0–6.0 cm in diameter), with an attached appendix measuring 7.0 cm in length (0.5–1.0 cm in diameter). The bowel is opened along the mesenteric border. At the ileocecal valve/orifice, there is a large cauliflower-like exophytic mass measuring 8.0 × 7.5 × 6.0 cm, occupying the entire lumen. Grossly, the tumor is suspected to extend into the pericolic (extramural) adipose tissue. The cut surface is gray-white, firm, and poorly demarcated from the surrounding tissue; the serosa is roughened. The remainder of the bowel is grossly unremarkable. CKpan(+),CK7(-),CK20(-),CEA(+),ki-67(70%+),D2-40(-),CD31(-),P53(-),S-100(+),MLH1(-),MSH2(+++),MSH6(+++),PMS2(-). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                I8
                		 88 F 67 Lymph node Metastatic cancer from colon * T3N1aM0 IIIB Metastasis Right hemicolectomy (ileocecal segment): The specimen includes 8 cm of ileum (3.0 cm in diameter) and 25.5 cm of colon (3.0–6.0 cm in diameter), with an attached appendix measuring 7.0 cm in length (0.5–1.0 cm in diameter). The bowel is opened along the mesenteric border. At the ileocecal valve/orifice, there is a large cauliflower-like exophytic mass measuring 8.0 × 7.5 × 6.0 cm, occupying the entire lumen. Grossly, the tumor is suspected to extend into the pericolic (extramural) adipose tissue. The cut surface is gray-white, firm, and poorly demarcated from the surrounding tissue; the serosa is roughened. The remainder of the bowel is grossly unremarkable. CKpan(+),CK7(-),CK20(-),CEA(+),ki-67(70%+),D2-40(-),CD31(-),P53(-),S-100(+),MLH1(-),MSH2(+++),MSH6(+++),PMS2(-). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                I9
                		 89 F 52 colon Colon cancer * T3N1bM0 IIIB Malignant Mesenteric root lymph node: One fatty tissue fragment measuring 2.0 × 0.5 × 0.6 cm. Proximal margin specimen: One mucosal tissue fragment measuring 0.7 cm in length and 1.2 cm in diameter. Distal margin specimen: One mucosal tissue fragment measuring 2.0 cm in length and 2.2 cm in diameter. Appendix: One appendix measuring 5.5 cm in length and 0.5–0.8 cm in diameter; the serosa is congested/hyperemic and the lumen contains fecal material. Sigmoid colon specimen: A segment of sigmoid colon measuring 11 cm in length and 3.0–3.5 cm in diameter, opened along the antimesenteric border. An exophytic mass is identified 3.5 cm from one resection margin and 6.0 cm from the opposite margin, measuring 4.0 × 3.5 × 1.0 cm and protruding 0.8 cm above the mucosa. Grossly, the tumor extends into the pericolic adipose tissue. The cut surface is gray-white, solid, and firm, poorly demarcated from the surrounding tissue; the serosal surface is dull/irregular. The remaining bowel is grossly unremarkable. Twenty-one pericolic lymph nodes are identified, measuring 0.3–0.8 cm. MLH1(+),MSH2(++),MSH6(+++),PMS2(++),CEA(+),CK7(-),CK20(+),ki-67(40%+),P53(-),Her-2(0),S-100(+),D2-40(-),CD31(-). Oxaliplatin + capecitabine (9 cycles). Both parents alive. Alive. *
                I10
                		 90 F 52 Lymph node Metastatic cancer from colon * T3N1bM0 IIIB Metastasis Mesenteric root lymph node: One fatty tissue fragment measuring 2.0 × 0.5 × 0.6 cm. Proximal margin specimen: One mucosal tissue fragment measuring 0.7 cm in length and 1.2 cm in diameter. Distal margin specimen: One mucosal tissue fragment measuring 2.0 cm in length and 2.2 cm in diameter. Appendix: One appendix measuring 5.5 cm in length and 0.5–0.8 cm in diameter; the serosa is congested/hyperemic and the lumen contains fecal material. Sigmoid colon specimen: A segment of sigmoid colon measuring 11 cm in length and 3.0–3.5 cm in diameter, opened along the antimesenteric border. An exophytic mass is identified 3.5 cm from one resection margin and 6.0 cm from the opposite margin, measuring 4.0 × 3.5 × 1.0 cm and protruding 0.8 cm above the mucosa. Grossly, the tumor extends into the pericolic adipose tissue. The cut surface is gray-white, solid, and firm, poorly demarcated from the surrounding tissue; the serosal surface is dull/irregular. The remaining bowel is grossly unremarkable. Twenty-one pericolic lymph nodes are identified, measuring 0.3–0.8 cm. MLH1(+),MSH2(++),MSH6(+++),PMS2(++),CEA(+),CK7(-),CK20(+),ki-67(40%+),P53(-),Her-2(0),S-100(+),D2-40(-),CD31(-). Oxaliplatin + capecitabine (9 cycles). Both parents alive. Alive. *
                J1
                		 91 F 57 colon Colon cancer * T2N1aM0 IIIA Malignant Colon specimen (sigmoid colon): A segment of bowel measuring 13.5 cm in length and approximately 2.5 × 1.5 cm in caliber. The bowel is opened along the antimesenteric border. An exophytic (polypoid) mass is identified, measuring 2.5 × 2.7 × 0.8 cm. Appendix: One appendix measuring 4.2 cm in length and 0.7 cm in diameter. CKpan(++),CK7(-),CK20(++),CEA(++),Ki-67(80%+),P53(weakly+),MSH6(++),MSH2(++),MLH1(++),PMS2(++),Her-2(-). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                J2
                		 92 F 57 Lymph node Metastatic cancer from colon * T2N1aM0 IIIA Metastasis Colon specimen (sigmoid colon): A segment of bowel measuring 13.5 cm in length and approximately 2.5 × 1.5 cm in caliber. The bowel is opened along the antimesenteric border. An exophytic (polypoid) mass is identified, measuring 2.5 × 2.7 × 0.8 cm. Appendix: One appendix measuring 4.2 cm in length and 0.7 cm in diameter. CKpan(++),CK7(-),CK20(++),CEA(++),Ki-67(80%+),P53(weakly+),MSH6(++),MSH2(++),MLH1(++),PMS2(++),Her-2(-). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                J3
                		 93 F 57 colon Cancer adjacent colon tissue * T2N1aM0 IIIA AT Colon specimen (sigmoid colon): A segment of bowel measuring 13.5 cm in length and approximately 2.5 × 1.5 cm in caliber. The bowel is opened along the antimesenteric border. An exophytic (polypoid) mass is identified, measuring 2.5 × 2.7 × 0.8 cm. Appendix: One appendix measuring 4.2 cm in length and 0.7 cm in diameter. CKpan(++),CK7(-),CK20(++),CEA(++),Ki-67(80%+),P53(weakly+),MSH6(++),MSH2(++),MLH1(++),PMS2(++),Her-2(-). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                J4
                		 94 F 67 colon Colon cancer * T3N1bM0 IIIB Malignant Sigmoid colon with attached fat: A segment of bowel measuring 12.5 cm in length and 2.3 cm in diameter. On opening, the mucosa shows a gray-pink, round elevation located 7.2 cm from one resection margin and 5.5 cm from the opposite margin. Beneath this, there is a gray-white, solid, firm nodule measuring 1.3 × 1.6 × 0.7 cm, not grossly involving the muscularis. The underlying adipose tissue forms a gray-white, solid, indurated nodular area, with mesenteric surface retraction/folding. Chest wall mass: One gray-white tissue fragment measuring 1.8 × 1.1 × 0.5 cm; the cut surface is gray-brown and solid. Ki-67(80%+),CP53(++),CK7(-),CK20(+),MLH1(+),MSH2(+),MSH6(+),PMS2(+),Her-2(0),S-100(-),CD31(-),D1-40(-). Oxaliplatin + capecitabine; immunotherapy added after the 6th cycle (oxaliplatin + capecitabine + camrelizumab). Both parents alive; mother had early-stage lung cancer, status post surgery (6 years). Alive. *
                J5
                		 95 F 67 Lymph node Metastatic cancer from colon * T3N1bM0 IIIB Metastasis Sigmoid colon with attached fat: A segment of bowel measuring 12.5 cm in length and 2.3 cm in diameter. On opening, the mucosa shows a gray-pink, round elevation located 7.2 cm from one resection margin and 5.5 cm from the opposite margin. Beneath this, there is a gray-white, solid, firm nodule measuring 1.3 × 1.6 × 0.7 cm, not grossly involving the muscularis. The underlying adipose tissue forms a gray-white, solid, indurated nodular area, with mesenteric surface retraction/folding. Chest wall mass: One gray-white tissue fragment measuring 1.8 × 1.1 × 0.5 cm; the cut surface is gray-brown and solid. Ki-67(80%+),CP53(++),CK7(-),CK20(+),MLH1(+),MSH2(+),MSH6(+),PMS2(+),Her-2(0),S-100(-),CD31(-),D1-40(-). Oxaliplatin + capecitabine; immunotherapy added after the 6th cycle (oxaliplatin + capecitabine + camrelizumab). Both parents alive; mother had early-stage lung cancer, status post surgery (6 years). Alive. *
                J6
                		 96 F 67 colon Cancer adjacent colon tissue * T3N1bM0 IIIB AT Sigmoid colon with attached fat: A segment of bowel measuring 12.5 cm in length and 2.3 cm in diameter. On opening, the mucosa shows a gray-pink, round elevation located 7.2 cm from one resection margin and 5.5 cm from the opposite margin. Beneath this, there is a gray-white, solid, firm nodule measuring 1.3 × 1.6 × 0.7 cm, not grossly involving the muscularis. The underlying adipose tissue forms a gray-white, solid, indurated nodular area, with mesenteric surface retraction/folding. Chest wall mass: One gray-white tissue fragment measuring 1.8 × 1.1 × 0.5 cm; the cut surface is gray-brown and solid. Ki-67(80%+),CP53(++),CK7(-),CK20(+),MLH1(+),MSH2(+),MSH6(+),PMS2(+),Her-2(0),S-100(-),CD31(-),D1-40(-). Oxaliplatin + capecitabine; immunotherapy added after the 6th cycle (oxaliplatin + capecitabine + camrelizumab). Both parents alive; mother had early-stage lung cancer, status post surgery (6 years). Alive. *
                J7
                		 97 F 63 colon Colon cancer * T3N1bM0 IIIB Malignant Sigmoid colectomy specimen: A segment of bowel measuring 18 cm in length and 4.5 cm in diameter. A circumferential ulcerated lesion is identified 4.3 cm from one resection margin and 8.0 cm from the opposite margin. The ulcer measures 5.8 × 2.5 cm with a depth of 0.8 cm. On cut section, the lesion grossly extends into the subserosal/pericolic adipose tissue. A metallic mesh/stent is present at the tumor site. CK7(-),CK20(+),CEA(+),Her-2(0),MLH1(+),MSH2(+),MSH6(+),PMS2(+),Ki-67(60%+),P53(+++),CD31(-),D2-40(-). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                J8
                		 98 F 63 Lymph node Metastatic cancer from colon * T3N1bM0 IIIB Metastasis Sigmoid colectomy specimen: A segment of bowel measuring 18 cm in length and 4.5 cm in diameter. A circumferential ulcerated lesion is identified 4.3 cm from one resection margin and 8.0 cm from the opposite margin. The ulcer measures 5.8 × 2.5 cm with a depth of 0.8 cm. On cut section, the lesion grossly extends into the subserosal/pericolic adipose tissue. A metallic mesh/stent is present at the tumor site. CK7(-),CK20(+),CEA(+),Her-2(0),MLH1(+),MSH2(+),MSH6(+),PMS2(+),Ki-67(60%+),P53(+++),CD31(-),D2-40(-). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                J9
                		 99 F 63 colon Cancer adjacent colon tissue * T3N1bM0 IIIB AT Sigmoid colectomy specimen: A segment of bowel measuring 18 cm in length and 4.5 cm in diameter. A circumferential ulcerated lesion is identified 4.3 cm from one resection margin and 8.0 cm from the opposite margin. The ulcer measures 5.8 × 2.5 cm with a depth of 0.8 cm. On cut section, the lesion grossly extends into the subserosal/pericolic adipose tissue. A metallic mesh/stent is present at the tumor site. CK7(-),CK20(+),CEA(+),Her-2(0),MLH1(+),MSH2(+),MSH6(+),PMS2(+),Ki-67(60%+),P53(+++),CD31(-),D2-40(-). Oxaliplatin + capecitabine. Both parents alive. Alive. *
                J10
                		 100 F 61 colon Colon cancer * T3N1aM0 IIIB Malignant Partial resection of right colon, small intestine, and appendix: The right colon measures 16.5 cm in length and 3.0 cm in diameter; the small intestine measures 7.0 cm in length and 2.8 cm in diameter. The appendix measures 8.0 cm in length and 0.8–1.1 cm in diameter; the serosa is congested, and the lumen contains fecal material. A circumferential ulcerated mass is identified in the ascending colon, located 8.0 cm from the colonic margin and 11.5 cm from the small-bowel margin, measuring 5.5 × 4.0 × 1.8 cm with an ulcer depth of 1.3 cm. The cut surface is gray-white, solid, and firm; grossly the tumor extends into the pericolic adipose tissue, and the adjacent mucosa is edematous. Two additional polyps are identified: one 7.0 cm from the colonic margin measuring 0.8 × 0.5 × 0.5 cm, and another 8.0 cm from the colonic margin measuring 0.4 × 0.4 × 0.3 cm. MLH1(+),MSH2(+),MSH6(+),PMS2(+),CK7(-),CK20(+),Ki-67(80%+),P53(+),S-100(-),CD31(-),Her-2(0). Oxaliplatin + capecitabine. Both parents alive; mother and one sister have multiple adenomatous colorectal polyps. Alive. *
                K1
                		 101 F 65 colon Colon cancer * T4aN1bM0 IIIB Malignant Sigmoid colectomy specimen: A segment of sigmoid colon measuring 14.8 cm in length and 3.0–5.5 cm in diameter, opened along the antimesenteric border. An intraluminal stent is present and is removed. A circumferential ulcerated mass is identified 7.5 cm from one resection margin and 4.5 cm from the opposite margin, measuring 6.5 × 6.5 × 4.5 cm. The ulcerated surface is focally gray-white with dirty white exudate/slough. Grossly, the tumor extends into the serosal/pericolic adipose tissue. Additional mucosal lesions include: A polypoid elevation 2.8 cm distal to the tumor, measuring 0.6 × 0.5 × 0.5 cm. A polypoid elevation 1.7 cm proximal to the tumor, measuring 1.1 × 0.8 × 0.6 cm. An ulcer located 2.5 cm proximal to the proximal resection margin, measuring 3.2 × 1.2 cm. Appendix: One appendix measuring 6.5 cm in length and 0.6–0.8 cm in diameter; the serosa shows congestion; the lumen contains blood and fecal material. Adnexa (fallopian tube): One fallopian tube measuring 3.5 cm in length and 0.6–1.2 cm in diameter (fimbrial end present as described). CK7(-),CK20(+),P53(wild-type pattern),Ki-67(hotspot 60%+),D2-40(-),CD31(-),MSH2(+),MSH6(+),MLH1(+),PMS2(+). Oxaliplatin + capecitabine; bevacizumab added starting with the 4th cycle. Both parents alive. Alive. *
                K2
                		 102 F 81 colon Colon cancer * T3N1aM0 IIIB Malignant Sigmoid colectomy specimen: A segment of bowel measuring 11.5 cm in length and 1.5–3.3 cm in diameter, opened along the antimesenteric border. A discoid, elevated lesion is identified 2.5 cm from one resection margin and 4.5 cm from the opposite margin, measuring 6.3 × 5.8 × 0.8 cm. The surface is gray-red with central erosion and hemorrhage. D2-40(-),CD31(-),Ki-67(hotspot60%+),Her-2(0),MSH2(+),MSH6(+),MLH1(+),PMS2(+),P53(mutant-type pattern). Oxaliplatin + capecitabine. Both parents deceased; cause unknown. Deceased (6 months postoperatively). *
                K3
                		 103 M 59 colon Colon cancer * T4bN2bM1a IVA Malignant Right hemicolectomy specimen: An ulcerated mass is present in the ileocecal region, located 14.0 cm from one resection margin, measuring 12.0 × 7.5 × 2.0 cm. The cut surface is gray-white and solid. The appendix measures 7.5 cm in length and 0.7 cm in diameter. The greater omentum measures 30.0 × 15.0 × 1.5 cm. Separate specimen (retro-duodenal mass): One gray-red, irregular nodule measuring 6.0 × 4.5 × 3.7 cm; cut surface gray-white and solid. Syn(+, subset of cells),CK18(+),CDX-2(+),Ki-67(+, focally ~80%),MUC2(+),MLH1(+),PMS2(+),MSH6(+),MSH2(+),p53(-),p40(-),Vimentin(-),CgA(-),CD56(-) May–September: 6 cycles ELOX1 (oxaliplatin + capecitabine). October–November: 2 cycles ELOX1 + targeted therapy (oxaliplatin + capecitabine + bevacizumab). December & February: 2 cycles irinotecan + capecitabine + bevacizumab. April: Tumor markers increased and PET suggested progression; enrolled in a clinical study: pembrolizumab + lenvatinib mesylate. Father deceased due to colon cancer; mother alive. Alive (recurrent disease). KRAS mutation present. NRAS: no mutation detected. BRAF V600E: no mutation detected.
                K4
                		 104 * * * * * * * * * * * * * *
                K5
                		 105 M 56 colon Colon cancer * T4aN2aMla IVA Malignant Colon resection specimen: An ulcerated mass is identified 7.0 cm from one resection margin, measuring 7.0 × 5.0 × 5.0 cm. The cut surface is gray-white and solid. The appendix measures 5.0 cm in length and 1.0 cm in diameter. The greater omentum measures 10.0 × 9.0 × 4.0 cm and contains multiple nodules ranging from 0.3 to 1.0 cm in greatest dimension. CK18(+),CDX-2(+),Ki-6T(+,focally ~60%),MLH1(+) PMS2(+),MSH6(+),MSH2(+),p53(+),MUC2(-),p40(-),Vimentin (-),Syn (-), CgA(-),CD56(-). May–November: 9 cycles XELOX + targeted therapy (oxaliplatin + capecitabine + bevacizumab). November: Ascitic fluid positive for malignant cells. December: Regimen changed to FOLFIRI + targeted therapy (irinotecan + capecitabine + bevacizumab, as provided). Outcome: Alive; developed ascites 7 months postoperatively. Both parents alive; father with cerebral infarction (4 years). Alive; developed ascites 7 months postoperatively. KRAS mutation (exon 2, codon 12/13). NRAS mutation (somatic mutation involving exon 2/3/4). BRAF V600E: no mutation detected.
                K6
                		 106 M 60 colon Colon cancer (without lymph node and distant metastasis) * T4aN0M0 IIB Malignant A segment of bowel with an ulcerated mass located 12.0 cm from one resection margin, measuring 4.0 × 4.0 × 2.0 cm. The cut surface is gray-white and solid. CK18(+),CDX-2(+,subset of cells),Ki-67(+,focally ~60%),p53(+),MLH1(+),PMS2(+),MSHS(+),MSH2(+),MUC2(-),Vimentin(-),p40(-),Syn(-),CgA(-),CD56(-). May: XELOX (oxaliplatin + capecitabine). June–October: 5 cycles XELOX + immunotherapy (oxaliplatin + capecitabine + camrelizumab). November: Bowel obstruction (not due to tumor recurrence, per note). Thereafter: Oral capecitabine. Both parents alive; father with a long history of multiple colorectal adenomatous polyps. Alive; developed bowel obstruction 7 months postoperatively. *
                K7
                		 107 F 50 colon Colon cancer (without lymph node and distant metastasis) * T2N0M0 I Malignant A segment of bowel with two exophytic masses: Mass #1: Located 4.5 cm from one resection margin, measuring 3.5 × 3.0 × 1.0 cm; cut surface gray-white. Mass #2: Located 6.0 cm from one resection margin, measuring 1.0 × 1.0 × 0.5 cm; cut surface gray-white. CK18(+),CDX-2(+),Ki-67(+,focally ~60%),MUC2(+,subset of cells),MLH1(+),PMS2(+),MSH6(+),MSH2(+),p53(+),Syn(-),CgA(-),CD56(-),Vimentin(-),p40(-). No chemotherapy administered. Father alive; mother deceased (accidental). Alive. *
                K8
                		 108 F 50 colon Colon cancer (without lymph node and distant metastasis) * T2N0M0 I Malignant A segment of bowel with appendix and greater omentum. A polypoid/elevated mass is identified 9.0 cm from one resection margin, measuring 5.0 × 4.0 × 2.0 cm. The cut surface is gray-yellow and solid. The omentum measures 20.0 × 15.0 × 2.0 cm. The appendix measures 4.0 cm in length and 0.8 cm in diameter. CK18 (+), CDX2 (+), Ki-67 (+, focally ~60%), p53 (+, scattered cells), MUC2 (+, scattered cells), MLH1 (+, subset of cells), PMS2 (+, subset of cells), MSH6 (+, subset of cells), MSH2 (+, subset of cells), Syn (−), CgA (−), CD56 (−), Vimentin (−), p40 (−). No chemotherapy administered. Parents alive. Alive. *
                K9
                		 109 M 58 colon Colon cancer (without lymph node and distant metastasis) * T4aN0M0 IIB Malignant Resected segment of bowel. An ulceroinfiltrative lesion is identified 30.0 cm from one resection margin, measuring 7.0 × 6.0 × 4.0 cm. The cut surface is gray-white and solid. The appendix measures 3.0 cm in length and 1.0 cm in diameter. CK18 (+), p53 (+), Synaptophysin (+, scattered cells), Ki-67 (+, focally ~60%), MLH1 (+), PMS2 (+), MSH6 (+), MSH2 (+), CD117 (−), CD30 (−), CDX2 (−), p40 (−), Chromogranin A (−), CD56 (−). Received 6 cycles of mFOLFOX6 (oxaliplatin + leucovorin calcium [folinic acid] + 5-fluorouracil). Parents alive; father has cardiovascular disease. Alive. *
                K10
                		 110 M 73 colon Colon cancer (without lymph node and distant metastasis) * T4aN0M0 IIB Malignant Resected segment of bowel with appendix. An ulceroinfiltrative mass is identified at the ileocecal region, 27 cm from one resection margin, measuring 4.5 × 3.5 × 1.0 cm. The cut surface is gray-white and solid. The appendix measures 3.5 cm in length and 0.5–1.0 cm in diameter. MLH1 (+), PMS2 (+), MSH6 (+), MSH2 (+); Ki-67 (+, focally ~70%); CK18 (+), CDX2 (+), MUC2 (+); Synaptophysin (−), Chromogranin A (−), CD56 (−), Vimentin (−), p40 (−), p53 (−). Feb–Apr: 3 cycles of CapeOX/XELOX (oxaliplatin + capecitabine). Post-chemotherapy bone marrow suppression did not recover. May: regimen changed to mFOLFOX (oxaliplatin + 5-fluorouracil + leucovorin). History of cardiovascular disease and poor performance status. Parents deceased,cause unknown. Deceased 11 months postoperatively due to cardiovascular complications (cardiovascular disease). *
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