PMC3654716_01
Preoperative image showing huge lump located in the anterior abdominal wall.
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fig1
CT scan showing mass arising from anterior abdominal musculature.
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fig2
No evidence of free fluid was seen in pelvic and peritoneal cavity (Figure 2). 
MRI images.
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fig3
MRI abdomen and pelvis (Figures 3(a) and 3(b)) revealed a large mass, measuring 20.6 (SI) x 24.6 (RL) x 14.6 (AP) cm arising from the right anterior abdominal wall musculatures having large component superficial to the muscle plane and similar large component deep/abdominal cavity to the muscles plane with central necrotic component.
Intraoperative image.
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fig4
After preoperative workup, patient was planned for operation, and complete excision of the tumor (Figure 4) with wide surgical margins along with the anterior abdominal wall down to the peritoneum was performed, resulting in a large wall defect of about 18 x 20 cm which was repaired after mobilization and release of rectus abdominis and reconstructed with polypropylene + Monocryl mesh (Figure 5).
Image showing reconstruction of defect with mesh.
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fig5
After preoperative workup, patient was planned for operation, and complete excision of the tumor (Figure 4) with wide surgical margins along with the anterior abdominal wall down to the peritoneum was performed, resulting in a large wall defect of about 18 x 20 cm which was repaired after mobilization and release of rectus abdominis and reconstructed with polypropylene + Monocryl mesh (Figure 5).
Showing excised specimen.
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fig6
Excised mass was heavy weighing 6.5 kg (Figure 6), and on cut section, it was gritty texture and glistening white in colour (Figure 7). 
Cut section of the tumor.
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fig7
Excised mass was heavy weighing 6.5 kg (Figure 6), and on cut section, it was gritty texture and glistening white in colour (Figure 7). 