PMC4560135_01
PMC4560135_02
Physical findings on initial examination. The tumor in the left axilla was fist-sized, solid, and immovable. A scar from a biopsy incision overlay the tumor
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Fig1
Examinations: Physical findings on initial examination included an elastic, hard, fist-sized tumor in the left axilla; the tumor was solid and immovable (Fig. 1).
Contrast-enhanced chest computed tomography. The tumor in the left axilla measured 11 cm x 7 cm x 11 cm. It had a relatively distinct border, but its surface was irregular
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Fig2
Contrast-enhanced chest computed tomography showed a tumor measuring 11 cm x 7 cm x 11 cm, with relatively distinct borders, but irregular surfaces (Fig. 2).
Histopathological biopsy findings. a Hematoxylin-and-eosin staining (high-power field). Atypical epithelial cells with spindle-shaped nuclei and rich cytoplasm were present in dense sheets. b S-100 staining. The tumor was strongly and diffusely positive for S-100 protein
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Fig3
Histology: Histopathological examination of a biopsy specimen showed densely sheathed atypical epithelial cells with spindle-shaped nuclei and rich cytoplasm (Fig. 3a). The tumor was strongly and diffusely positive for vimentin, S-100 protein (Fig. 3b), and neuron-specific enolase, a pattern of immunoreactivity differing from that of conventional MPNST.
PMC4560135_03
PMC4560135_04
PMC4560135_05
Pathological autopsy. Metastatic tumor cells were found in the peritoneum, lymph nodes, pharynx, pleura, lungs, pericardium, endocardium, myocardium, liver, omentum, pancreas, splenic hilum, stomach, jejunum, ileum, transverse colon, appendix, and bone marrow. Informed consent to publish this photograph was obtained from the patient before death and from the patient's family after death
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Fig4
Pathology at autopsy (Fig. 4): An autopsy was performed 24 h after death.