PMC6008691_01
MRI image of a T2-weighted sagittal section. A huge abdominal tumor derived from the uterus, presenting with uneven intratumor signal.
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The tumor showed an uneven signal on T2-weighted sagittal section (Figure 1), and the enhanced MRI study showed that the tumor edge but not the center was enhanced (Figure 2).
MRI image of a Gadolinium enhanced T1-weighted coronal section. The center of the abdominal tumor was not enhanced, implicating a suspicion of necrosis in the center.
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The tumor showed an uneven signal on T2-weighted sagittal section (Figure 1), and the enhanced MRI study showed that the tumor edge but not the center was enhanced (Figure 2).
Intraoperative findings of the abdominal tumor. The surgery revealed a huge tumor occupying the space from the pelvis to the diaphragm. The tumor surface was smooth and hard with many dilated veins.
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The tumor surface was smooth and hard with many dilated veins (Figure 3).
Gross findings of the excised tumor. The size of the tumor was 28 x 23 cm and the weight was 7600g. The tumor showed continuity with the posterior wall of the uterus.
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Macroscopic findings of the tumor revealed a well-circumscribed tumor showing extensive continuity with the posterior wall of the uterus, measuring 28 x 23 cm (Figure 4).
Macroscopic findings of sections of the tumor. On the sliced surface of the tumor, an obvious heterogeneous pattern was recognized within the mixture of a white homogeneous area, suggesting benign uterine fibroids, and a vulnerable part, due to bleeding and necrosis.
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On the sliced surface of the tumor, an obvious heterogeneous pattern was recognized within the mixture of a whitish homogeneous area, suggesting benign uterine fibroids, and a vulnerable area, due to bleeding and necrosis (Figure 5).
Microscopic findings of the tumor (H.E. stain; original magnification X40). The tumor was mostly composed of spindle-shaped cells, consistent with degenerated leiomyoma. Enlargement of blood vessels was observed within an area of about 2 cm x several mm, and proliferation of atypical cells showing a fine meshwork microvascular structure was observed in the blood vessel cavity.
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However, enlarged blood vessels were observed within an area of approximately 2 cm x several mm, and proliferation of atypical cells showing a fine meshwork microvascular structure was observed in the blood vessel cavity (Figure 6).
Microscopic findings of the tumor (H.E. stain; original magnification X400). These atypical cells consisted of various contours, such as cubic, polygonal, and short spindle shape. The nucleus was circular with a high degree of vacuolar enlargement and pleomorphism. Abnormal mitotic figures were also interspersed.
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Abnormal mitotic figures were also interspersed (Figure 7).
Immunohistochemical findings of the tumor (ERG; original magnification X400). The cytoplasm of the tumor cells was strongly positive for ERG stains.
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Immunohistochemical findings of the tumor (CD31; original magnification X400). The cytoplasm of the tumor cells was diffusely positive for CD31 stains.
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