PMC4320915_01
Preoperative contrast-enhanced abdominal CT scan: (a) the sagittal projection shows a large and well-defined, 32 x 29 x 15 cm, heterogeneously enhanced mass that displaces and compresses posteriorly the abdominal organs; (b) the axial projection shows some parts composed of irregular tissue showing enhancement; others are hypodense with cystic aspects and contextual septa.
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It showed a large (32 x 29 x 15 cm) heterogeneously enhanced mass with well-defined margins (Figure 1(a)). Some parts of this mass seemed to be composed of irregular tissue showing enhancement; others were hypodense with cyst-like appearance and contextual septa (Figure 1(b)).
Intraoperative image: laparotomy shows a solid abdominal tumor clearly separated. The mass occupies most of the upper quadrants of the abdomen, originated from the omentum.
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A complete surgical excision of the lesion was performed revealing a solid abdominal tumor clearly separated, but in close proximity to adjacent organs (Figure 2).
Microscopically image: histological examination shows scattered lymphocytes and plasma cells are admixed with spindle cells, hematoxylin and eosin stain, original magnification 200x.
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Macroscopic examination revealed a well-demarcated mass measuring 26 cm at the greatest diameter and grayish color (Figure 3).
Surgical specimen: voluminous solid lesion measuring 26 cm at the greatest diameter.
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Microscopic examination showed a mesenchymal neoplasm benign/borderline (spindle-cell fibromyofibroblastic proliferation with morphological characteristics indicative of low malignant potential), in smooth muscle differentiation, composed of cells with eosinophilic cytoplasm and oval nuclei, with mild and focal nuclear atypia, mixed with elements between lymphocytes and plasma cells and rare eosinophils, in a soft stroma with strong regressive pseudocystic aspects and edematous-hemorrhagic phenomena and vascular dilations (Figure 4).