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. This evidence concerns the gene MLANA and neoplasm with perivascular epithelioid cell differentiation.