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MRI abdominal scan showing a large solid mass between the left hepatic lobe, the stomach and the retroperitoneum.
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A computed tomography scan (CT scan) and a magnetic resonance imaging (MRI) of her abdomen both showed a large mass (maximum diameter 12 cms) that was confined between the left hepatic lobe, the stomach and the retroperitoneum (Fig. 1).
Intraoperative exposure of lesser sac containing the tumour.
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On exploratory laparotomy, after entering the lesser sac a large solid tumour was found located posterior to the gastric wall and anterior to the pancreas (Fig. 2).
The specimen measured approximately 5 inches (equal to 12.7 centimetres).
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There was a clear plane of dissection without invasion of either organ and a complete resection of the mass was performed with safety (Fig. 3).
Haematoxylin - eosin staining showing spindle cells with severe pleomorphism (magnification x10).
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Histological examination revealed spindle cells with severe pleomorphism (Fig. 4) and high mitotic activity (mitotic count of 8 mitoses/50 high-power fields).
Immunohistochemical staining was positive for CD117 (magnification x10).
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Immunohistochemically, the tumour cells showed strong positivity for c-kit (CD117) (Fig. 5), DOG-1 and human haematopoietic progenitor cell antigen (CD34).