PMC10412926_01
Changes in the left lower limb mass. (A) before treatment; (B) after ten days; (C) after one month.
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Physical examination revealed swelling in the left lower extremity, with a circumference of 29 cm ( Figure 1A ), local skin temperature, and limited mobility, while the right lower extremity had a circumference of 20 cm with normal mobility. After ten days of treatment, the circumference of the left thigh decreased to 24.5 cm ( Figure 1B ). One month of follow-up showed a further reduction in circumference to 20 cm ( Figure 1C ), and ultrasound B revealed a mass size of 6.0 cm x 5.0 cm x 3.0 cm.
Imaging results. (A) MRI examination of the lower limb: a circular soft tissue mass in the left lower limb, measuring 8.25cm x 8.72cm x 7.86cm, closely adjacent to the femur and surrounding it, with unclear demarcation from the surrounding muscle tissue, and mixed-signal intensity in the mass. (B) enhanced CT of the lower limb: the mass is mainly supplied by the left femoral artery, with flux into the femoral vein, and many tortuous vessels are visible within the lesion. (C, D) MRI of the lower extremity revealed a significant mass reduction after four months of treatment.
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But it still wrapped around the femur, and the boundary with the surrounding muscles is unclear( Figures 2C, D ).
Pathology (microscopic examination shows spindle-shaped tumor cells with eosinophilic cytoplasm and frequent mitotic figures).
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Subsequently, an ultrasound-guided fine-needle biopsy of the left thigh mass was performed under general anesthesia, and the histopathological results ( Figure 3 ) suggested a soft tissue tumor with spindle cells.
Immunohistochemistry (immunohistochemical monoclonal antibodies to Vimentin, SMA, Desmin, MyoD1, Ki-67, and CD34, respectively).
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Figure 4 ). Fluorescence in situ hybridization (FISH) revealed ETV6 gene breakage ( Figure 5 ).
Fluorescence in situ hybridization (FISH) (separate red and green signals revealed ETV6 breakage).
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Figure 4 ). Fluorescence in situ hybridization (FISH) revealed ETV6 gene breakage ( Figure 5 ).
PMC10412926_02
Imaging results. (A) MRI examination of the lower limb: a circular soft tissue mass in the left lower limb, measuring 8.25cm x 8.72cm x 7.86cm, closely adjacent to the femur and surrounding it, with unclear demarcation from the surrounding muscle tissue, and mixed-signal intensity in the mass. (B) enhanced CT of the lower limb: the mass is mainly supplied by the left femoral artery, with flux into the femoral vein, and many tortuous vessels are visible within the lesion. (C, D) MRI of the lower extremity revealed a significant mass reduction after four months of treatment.
fonc-13-1206833-g002.jpg
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But it still wrapped around the femur, and the boundary with the surrounding muscles is unclear( Figures 2C, D ).