PMC3546097_01
Infantography shows a large amount of free-air in peritoneal cavity before operation.
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F1
A plain abdominal radiograph showed normal air-filled loops of bowel; however a large amount of free air occupied the central portion of the abdomen (Fig. 1).
Grossly it shows a round mass wrapping around a sigmoid colon.
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F2
A round mass, about 5 cm in diameter, was observed in the left lower abdominal cavity, and it seemed to wrap around a loop of sigmoid colon (Fig. 2).
A hypercellular and poorly circumscribed tumor mass in submucosa and muscularis proper (H&E stain, x 40), atypical spindle cells forming fascicular arrangement with mitoses and small amount of interstitial collagen in inlet (H&E stain, x 400).
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F3
Pathologic analysis report described an infantile fibrosarcoma, measuring about 4.7 x 2.8 cm, involving mainly the submucosa and muscularis propria with an infiltrative growth pattern (Fig. 3).
Immunohistochemical stains of tumor cells. Positive for vimentin and smmoth muscle actin (SMA, x 200) in A, Ki-67 proliferation index 20% in B, negative for desmin (desmin, x 200) and h-caldesmon (h-caldesmon, x 200) in C, D.
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F4
The immunohistochemical stain of the tumor was positive for vimentin and SMA, and negative for h-caldesmon, S-100, CD34, c-kit, desmin, and ALK-1 (Fig. 4).
Follow-up PET-CT shows no abnormal uptakes, evidence of tumor recurrence, 12 months later after operation.
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F5
Radiologic evaluation showed no evidence of tumor recurrence 12 months postoperatively (Fig. 5).