PMC4314827_01
Physical findings in the patient. A) Multiple melanotic macules on the fingertips characteristic or Peutz-Jeghers syndrome, B) Melanotic macule on the right cheek.
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Fig1
Suspicion of PJS was raised by intraoperative consultation with medical genetics based on the presence of pedunculated small bowel polyps and additional findings on physical examination of the patient, which included multiple hyperpigmented areas on her fingertips (Figure 1A).
Pathologic findings of the patient's tumor. A) Area of endometriosis adjacent to the tumor. B) Endometrial stromal sarcoma, low grade. C) Endometrial stromal sarcoma, low grade area, focally positive for CD10. D) Endometrial stromal sarcoma, epithelioid component. E) Endometrial stromal sarcoma spindle cell component estrogen receptor positive F) Endometrial stromal sarcoma, epithelioid component, Pancytokeratin positive.
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PMC4314827_01_13053_2015_Article_27_Fig2_HTML.jpg
Fig2
Pathological examination showed a 9.5 cm malignant neoplasm consistent with high-grade endometrioid stromal sarcoma with a predominant epithelioid component (Figure 2A-F) and a definitive sarcomatous component with prominent sex cord differentiation.
Immunohistochemistry (IHC) for STK-11 of patient's tissues. A) IHC for STK-11 of the hamartomatous polyp and B) the endometrial stromal sarcoma. Images were obtained at 20X using Scanscope XT (Aperio Technologies, Vista, CA).
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Fig3
IHC studies demonstrated STK-11 expression in the hamartomatous polyp with decreased expression of STK-11 in the sarcoma tumor tissue (Figure 3).