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Postoperative pathological results showed an extramural rectal tumor with necrosis and significant desmoplasia, while IHC showed PAX-8 (+), PAX-2 (), CK7 (+), CK20 (), CK5/6 (), CDX-2 (), GATA-3 (), Calretinin (), D2-40 (), WT-1 (), GCDFP-15 (), AR (), ER (minimal, +), NapsinA (), and Ki-67 (+) in about 30%, which was consistent with metastatic adenocarcinoma and liver tumor with diffuse necrosis ( Figure 4 )

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