PMEL and neoplasm with perivascular epithelioid cell differentiation: These tests typically show positivity for markers associated with PECs, such as SMA, actin, and calponin, alongside markers for melanocytes like HMB45 and Melan-A.14) In this specific case, the diagnosis of PEComa was confirmed by the presence of spindle-shaped cell proliferation and positive immunostaining for SMA, HBM45, and Melan A. It is still difficult to make a preoperative diagnosis of colonic PEComa based solely on imaging, and there are no clear reports on this so far.