PMC9950396_01
Ultrasonography of leiomyosarcoma in the caudal epididymis, (A, B) longitudinal scan, (C, D) transverse scan. There is a solid hypoechoic mass with heterogeneous internal echogenicity, clear boundaries, and abundant blood flow signals.
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On ultrasound imaging, an heterogeneous hypoechoic mass was seen in the tail of the left epididymis, approximately 3.0 x 2.0 cm in size, with a clear boundary, unsmooth margin, local angulation, and no obvious lateral shadow, Doppler US revealed that the tumors were hypervascular. ( Figure 2 ).
(A) The gross specimen of the tumor is grayish white, braided, tough and poorly defined. (B) Hematoxylin and eosin-stained slices show spindle-shaped or pleomorphic tumor cells, with obvious cell atypia and more mitotic figures. (C) Eosinophilic cytoplasm of the tumor cells. The nuclei are rod-shaped, round, or cigar-like at both ends. The chromatin is rough and the nucleoplasmic ratio is increased, with some irregular nuclei. Nucleoli and mitotic figures are visible, and interstitial inflammatory cells are scattered and infiltrated. (D) Caldesomon is diffusely and positively expressed in the tumor cells. (E) Desmin is diffusely and strongly expressed in the tumor cells. (F) SMA is positively expressed in the epididymal smooth muscle cells.
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In the epididymal tissue, expression of smooth muscle actin (SMA), prostate-specific antigen (PSA), and compound prostate-specific antigen (CPSA) had increased ( Figure 3 ).