PMC8728798_01
pre-operative image
PAMJ-40-187-g001.jpg
PMC8728798_01_PAMJ-40-187-g001.jpg
F1
Clinical findings: physical examination revealed (Figure 1) a single swelling of size 15x10 cm present over the posterior aspect of Left arm, 20cm inferior to the Left acromion process and 15cm inferior to the Left olecranon process smooth in surface, hard in consistency and swelling- mobility restricted on triceps muscle contraction.
MRI left arm showing large lobulated solid cystic space
PAMJ-40-187-g002.jpg
PMC8728798_01_PAMJ-40-187-g002.jpg
F2
MRI left arm impression was large lobulated solid cystic space occupying lesion of size 9.5cmx5.6cm x5.4cm intramuscularly in the triceps muscle-possibility of neoplastic lesion (Figure 2).
intra-operative picture showing median nerve
PAMJ-40-187-g003.jpg
PMC8728798_01_PAMJ-40-187-g003.jpg
F3
Therapeutic intervention: after obtaining cardiology and anaethetic fitness patient was preceded for wide local excision of triceps muscle with left lattismus dorsi flap reconstruction with split skin grafting of the raw area of the back (Figure 3).
post-operative image
PAMJ-40-187-g004.jpg
PMC8728798_01_PAMJ-40-187-g004.jpg
F4
Graft was healthy (Figure 4).
histological section showing embryonal rhabdomyosarcoma
PAMJ-40-187-g005.jpg
PMC8728798_01_PAMJ-40-187-g005.jpg
F5
Histopathology report showed high grade sarcoma, histomorphology favoring embryonal rhabdomyosarcoma and immunhistochemistry showed vimentin and Tle -1 positive which concluded with synovial cell sarcoma (Figure 5).