PMC4729324_01
The cutaneous lesion, which included ulcers and foci of bleeding.
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In his physical examination, a giant mass, exhibiting ulcers and umbilications, as well as superficial bleeding regions, was present on the anterior wall of the abdomen, with the approximate dimensions of 45x35x15 cm (Figure 1).
Computerized tomography image of the mass.
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This mass was significantly compressing the posterior structures of the abdominal wall, and causing skin ulcers (Figure 2).
Intraoperative image that shows adhesions to anterior rectus fascia.
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The mass was surrounded by a pseudo-capsule and had partial adhesions to the anterior rectus fascia (Figure 3).
Anterior rectus sheath repair with a polyprolene patch.
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The defect at the fascia was repaired with polyprolene mesh as a patch (Figure 4).
After reconstruction with an anterolateral pediculated thigh flap.
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The defect at the abdominal wall, sized 30x30 cm, was closed with an anterolateral pediculated thigh flap (Figure 5).
Fusiform tumor cells that were extending in various directions (H&O x200).
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In histopathological evaluation, the tumor formation was characterized by a number of atypical cells extending in various directions as clusters that were fusiform and spindle-like, and had obtuse ends, with hyperchromatic nuclei and pale eosinophilic cytoplasms (Figure 6).
Smooth muscle actin immunoreactivity in tumor cells (DAB x400).
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Although immunohistochemical studies revealed immunoreactivity with vimentin and smooth muscle actin, there was no immunoreactivity with CD 117 or S100 in tumor cells (Figure 7).