PMC6142721_01
(a-d) CT scan with intravenous contrast (sagittal view): the tumor seemed to be divided into two parts. The right part was like a single cystic lesion; the left part contained a solid component.
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fig1
CT showed a giant tumor occupying the majority of the abdominal cavity (Figures 1(a)-1(d) and 2(a)-2(c)).
(a) MRI (coronal view, T1W1): tumor had generally low signal density, but some parts had high signal density. (b) MRI (coronal view, T2W1): tumor had high signal intensity.
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fig3
Magnetic resonance imaging (MRI) showed the tumor had almost entirely low signal density, but T1-weighted image (T1WI), some parts had high signal density (Figure 3(a)). In T2-weighted image (T2WI), on the other hand, the tumor showed high signal intensity (Figure 3(b)).
(a) Operative findings: the tumor was attached to the stomach and omentum (white arrow). (b) Operative findings: tumor also adhered to the pancreatic tail (black arrow).
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fig4
A lower midline incision was performed to observe the large tumor contained within a membrane (Figure 4(a)). Furthermore, the tumor was also strongly in contact with the pancreatic tail (Figure 4(b)).
(a) Specimen: size was 30 x 25 x 10.5 cm. (b) Specimen: right side of the tumor was a cystic component with wall thickening (red arrow). (c) Specimen: when tumor was incised, there was a mixture of solid components (blue arrow) and parts of honeycomb-like texture (green arrow).
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fig5
The tumor is shown in Figures 5(a)-5(c).
(a) Specimen (HE staining): spindle-shaped or star-shaped tumor cells proliferate diffusely with abundant collagen fiber. (b) Specimen (beta-catenin staining): beta-catenin was positive in the tumor cell nucleus.
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fig6
Beta-catenin was positive in the tumor cell nucleus on immunohistochemistry (Figures 6(a) and 6(b)).