PMC6304189_01
Coronal T1-weighted fast spin-echo (T1FSE) MRI depicting the tumor as an enhancing mass at the cephalic part of the right sternocleidomastoid muscle.
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Past medical history included a resected desmoid tumor with free surgical margins from the same region six months ago in another center (Figure 1).
Axial T1-weighted fast spin-echo (T1FSE) MRI showing an enhancing mass indicative of local tumor recurrence following surgery.
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MRI revealed an enhancing mass at the cephalic third of the SCM, in close contact with the right IJV, with no signs of vessel infiltration (Figure 2).
Surgical excision of the desmoid tumor.
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The neoplasm was found to originate from the upper portion of the SCM, extending to the parapharyngeal space, and infiltrating the SAN (Figure 3).
End-to-end anastomosis of the stumps of the spinal accessory nerve after macroscopic complete resection of the desmoid tumor.
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However, remaining length of the nerve was satisfactory, and a microsurgical end-to-end anastomosis was performed (Figure 4).
Immunohistochemical staining of the biopsy specimen: (a) desmin; (b) smooth muscle actin; (c) vimentin; (d) beta-catenin.
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Immunohistochemically, neoplastic cells stained vimentin (Figure 5), smooth muscle actin (Figure 5), and desmin (Figure 5) and were negative for CD34. beta-Catenin nuclear staining was also present (Figure 5).