PMC3924737_01
(A) A large, lobulated, and heterogenously enhancing mass occupies the right retroperitoneal space (arrow). (B) Intraoperative findings: a 9.4 x 6.3 x 5.1 cm sized smooth round mass (arrow) surrounded by light grayish membrane is attached to right retroperitoneal wall close to the right adnexa (arrowhead).
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F1
Contrast-enhanced abdominal computerized tomography (CT) showed 9.4 x 6.3 x 5.1 cm sized lobulated mass in right pelvic cavity (Fig. 1A). The uterus and both adnexa showed normal appearance, however a 9 x 6 x 5 cm sized spherical mass with clear margin was found around right internal iliac artery in right retroperitoneal space (Fig. 1B).
Microscopic features of retroperitoneal leiomyosarcoma. (A) Low magnification of tumor showing intersecting fascicles (H&E, x100). (B) Tumor cells show strong reactivity for smooth muscle actin (smooth muscle actin, x400).
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F2
Pathologic examination revealed a high-grade leiomyosarcoma with spindle-shaped tumor cells arranged in fascicles with intermediate dysplasia and also rich mitotic cell division (Fig. 2A). On immunohistochemical staining, the sample showed positive results for vimentin, smooth muscle actin, and desmin; on the contrary, the sample was negative for CD31, CD34, and S-100 protein test (Fig. 2B).