PMC4921156_01
Two cutaneous leiomyomas visible on the patient's right arm.
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She had a past medical history significant for lupus, hypertension, stage III chronic renal failure, multiple painful skin lesions (Figure 1, Figure 2), and severe uterine fibroids requiring hysterectomy at age 23.
Multiple cutaneous leiomyomas of varying size and shape on the patient's right flank.
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She had a past medical history significant for lupus, hypertension, stage III chronic renal failure, multiple painful skin lesions (Figure 1, Figure 2), and severe uterine fibroids requiring hysterectomy at age 23.
Right renal mass is present containing calcifications (CT without contrast, 2010).
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Ultrasound (US) and noncontrast computed tomography (CT) evaluation showed a cortically based, partially exophytic mass, involving the lower pole of the right kidney, that demonstrated peripheral calcifications concerning for neoplasm (Fig. 3).
Renal tumor showing tubular pattern with oncocytic cells (H&E, 400x).
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The larger showed a mixed solid and tubular histologic pattern (Fig. 4).
Smaller tumor showing papillary type II morphology (H&E, 400x)
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The 1.0-cm tumor displayed morphologic features of type 2 papillary renal-cell carcinoma (Fig. 5).
Renal tissue with incipient neoplasia (PAS, 400x).
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The surrounding renal tissue showed an additional 1-mm papillary lesion and a <1-mm focus of incipient papillary neoplasia (Fig. 6).
New mass in the superior pole of the left kidney demonstrates heterogeneous enhancement (fat-saturated T1 post contrast, 2013).
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A new, solid, enhancing left renal lesion was seen in October 2013, which was suspicious for neoplasm (Fig. 7).
Mass in the superior pole of the left kidney demonstrates abnormally increased FDG uptake (FDG-PET, 2013).
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A positron emission tomography (PET) scan demonstrated this lesion to be fludeoxyglucose (FDG)-avid, with a standardized uptake value (SUV) of 4.9 (Fig. 8); it was new (as compared to the PET performed two years before).
Cutaneous leiomyoma with infiltration of subcutaneous fat (Desmin, 100x).
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Pathology showed minimal cytologic atypia and no mitotic activity but did show an infiltrative border, extending into subcutaneous fat (Fig. 9).