PMC6951396_01
(A) Vascular-appearing mass with bluish discoloration of the overlying skin at the right arm. (B) MRI T1-weighted image shows a large, well-defined, lobulated intramuscular mass at the mid and distal right arm, measuring 5.7 x 5.3 x 6.8 cm. (C) The tumor cells display uniform, round, oval to spindle shaped hyperchromatic nuclei and scanty cytoplasm. (D) On immunohistochemical staining the tumor cells are positive to vimentin.
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F1
On physical examination, the patient had a firm, non-pulsatile, vascular-appearing mass, 6 x 5 x 7-cm in size, with an overlying skin of bluish discoloration and a few bleeding spots (Figure 1A). T1-weighted sequence, and heterogeneously hyperintense on T2-weighted sequence (Figure 1B). The MRI findings were interpreted as being consistent with a bleeding intramuscular infantile hemangioma, and she was observed without any treatment. The histopathological examination showed dense cellular neoplastic spindle cells arranged in short interlacing fascicles with mild pleomorphism, and frequent mitoses (Figure 1C). BCL-2, S100, and positive for vimentin (Figure 1D). Based on these findings, a diagnosis of CIF was made.
PMC6951396_02
Sequence analysis for ETV6-NTRK3 fusion.
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F2
An ETV6(TEL)-NTRK3(TRKC) transcript was detected by reverse transcriptase-polymerase chain reaction, indicating the molecular diagnosis of CIF (Figure 2).