PMC9754323_01
Changes in the lesions identified by imaging. (A) T1-weighted image showing a lipoma (red arrowhead) in the right scrotum. (B) An abdominal-pelvic computed tomography scan showing a substantial mass (>5 cm; red arrowhead) in the right scrotum. (C) An abdominal-pelvic computed tomography scan showing a mass (>10 cm; red arrowhead) in the right retroperitoneum. (D) A 5-week postoperative computed tomography scan showing a left pleural effusion. (E) A computer tomography scan showing no pleural effusion following three cycles of doxorubicin monotherapy. (F) A computer tomography scan showing increased pleural effusion following six cycles of doxorubicin monotherapy.
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T1-weighted image. There was partial heterogeneity inside the mass, and a diagnosis of lipoma was made ( Figure 1A ). Abdominal-pelvic computed tomography (CT) scan showed a 50 x 70 x 68 mm3 substantial mass in the right scrotum and a 10 cm wide mass in the right retroperitoneum ( Figures 1B, C ). Five weeks after surgery, a CT scan showed increasing ascites and left pleural effusion ( Figure 1D ). After three cycles of DXR monotherapy, CT showed resolution of pleural effusion ( Figure 1E ). However, CT after six cycles again showed an increased pleural effusion ( Figure 1F ).
Histopathological examination of the right paratesticular mass. (A) Large adipocytes (haematoxylin and eosin staining x20). (B) A bundle-like proliferation of medium-sized spindle-shaped cells interspersed with low-grade atypical adipoblasts (haematoxylin and eosin staining x100). (C) Fibrosarcoma-like dedifferentiated liposarcoma (haematoxylin and eosin staining x200). (D) Immunostaining positive for MDM2 (x200). (E) Immunostaining negative for S-100 protein (x200).
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Histopathological studies indicated that the nodule was composed of a bundle-like proliferation of medium-sized spindle-shaped cells interspersed with low-grade atypical adipoblasts and large adipocytes ( Figures 2A-C ). Immunostaining was positive for MDM2 and negative for S-100 protein ( Figures 2D, E ).