PMC9058064_01
(A-C) Ultrasonography imaging. Multiple solid masses in the subcutaneously muscular layer, with size of 2.8 x 2.8 x 1.8 cm in bigger mass. Color Doppler flow imaging (CDFI) showed a strip-like blood flow signal.
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F1
In the subcutaneously muscular layer of the lower abdominal wall incision, there also were multiple solid masses with blood flow signal showed (Figures 1A-C).
(A,B) Pelvic cavity magnetic resonance imaging. Multiple nodes in the abdominal wall, in the right iliac fossa, and behind the uterus, with lower T1- and T2-weighted image. The bigger showed homogeneous enhancement on enhancement images in the soft tissue of the lower abdominal wall.
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F2
The enhanced scan was significantly enhanced but uniform. The size of uterus was normal without abnormal signal shadow found, and the enhancement was uniform (Figures 2A,B).
(A,B) Lesions seen interoperation. (A) Obvious lesions in fat layer and fascia. (B) Lesions in the back wall and sacral ligament of the uterus.
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F3
Others were found in the left-posterior wall of uterine (2 cm in size), and on the surface of the right sacral ligament (2 cm in size), which were close to the ureter and surrounding tissue (Figures 3A,B).
(A,B) Grossly tissue. Multiple solid nodules, varying in size from 0.5 to 4 cm.
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F4
The macroscopic tissue showed multiple solid nodules (Figures 4A,B).
Microscopic observation. (A) Pathology microscopically seen for the first surgery, in rich cell type with red degeneration and (B) Immunohistochemical finding: SMA(+), Desmin (+), myogenin(-), Ki-67(+2%), HMB-45(-), CD34(-), CD117(-), Dog1(-), ER(-), PR(2+) (H&E, 100x).
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F5
Immunohistochemistry showed that SMA(+), Desmin(+), myogenin(-), Ki-67(+2%), HMB-45(-), CD34 (blood S-100) (-), CD117 (-), dog1(-), ER(-), PR(+) (Figures 5A,B).