PMC3590509_01
Enhanced computed tomography (CT) of the abdomen revealed a slightly enhanced heterogeneous tumor, 18 mm in diameter, between the Spiegel lobe of the liver and the IVC in early-phase images ((a) arrow), with no enhancement and washout in late-phase images ((b) arrow).
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fig1
Enhanced computed tomography of the abdomen revealed a slightly enhanced heterogeneous tumor, 18 mm in diameter, between the Spiegel lobe of the liver and the IVC in early-phase images (Figure 1(a)), with no enhancement or washout in late-phase images (Figure 1(b)).
Magnetic resonance imaging (MRI) of the abdomen. Magnetic resonance imaging (MRI) of this tumor revealed a contrasting low intensity on the T1-weighted image ((a) arrow head) and high intensity on the T2-weighted image ((b) arrow head).
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Magnetic resonance imaging of this tumor revealed a contrasting low intensity on the T1-weighted image (Figure 2(a)) and high intensity on the T2-weighted image (Figure 2(b)).
The resected specimen was solid with a smooth surface.
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The resected specimen was solid with a smooth surface (Figure 3).
Histopathological findings. Microscopic examination revealed that the tumor consisted of uniform and spindle cells and had a fascicular growth pattern (Hematoxylin & Eosin: x600) (a). Immunohistochemical staining revealed that alpha-SMA (x600) (b) and HHF35 (x600) (c) were expressed in this tumor; MIB-1 index was about 60% (Ki67: x600) (d).
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This pathological feature was compatible with a mesenchymal tumor (Figure 4(a)). Immunohistochemical staining revealed that alpha-SMA and HHF35 were expressed in this tumor (Figures 4(b) and 4(c)), and c-kit and CD34 were negative. The MIB-1 index was about 60% (Figure 4(d)).
Enhanced computed tomography (CT) of the abdomen. The tumor was detected in the Spiegel of the liver on enhanced CT of the abdomen (arrow).
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After 12 months, the tumor was detected in the Spiegel of the liver on enhanced CT of the abdomen (Figure 5).
Computed tomography (CT) of the abdomen and chest. Multiple liver metastases (a) and lung metastases ((b) arrows) were detected on CT.
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Thirty-seven months after the operation, multiple liver and lung metastases were detected on CT (Figures 6(a) and 6(b)), and the patient died of multiple organic failures.