PMC6000728_01
CT scan shows a large mass in the pelvis in close relationship with bladder, right internal iliac vessels, sigmoid colon, ileal loops and first sacral vertebral body.
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Contrast enhanced-CT scans confirmed an hypodense solid mass of 5,8 x 5,6 x 5,4 cm (CC x AP x LL) with sharp and regular limits in the right pelvic space without sign of infiltration of surrounding structures (posterior wall of the bladder, the left internal iliac vessels, rectum, the first sacral vertebral body) (Fig. 1).
Laparoscopic exploration revealed a subperitoneal mass sited between the rectum, the bladder and the right common iliac vessels.
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The pelvic exploration confirmed the presence of a retroperitoneal mass located between the rectum, the bladder and the right common iliac vessels (Fig. 2).
Intraoperative shooting: dissection of the tumour from the capsule using blunt maneuvers.
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The dissection, using both sharp and blunt maneuvers, extended posteriorly and laterally both from the ureter and the right iliac vessels, paying attention to preserve the integrity of the capsule and ensuring meticulous hemostasis at all time by means of the harmonic scalpel (Fig. 3).
Left: solid sheets of spindle cells with occasional palisading; mitotic activity is absent (100x, HH staining). Right: strong and uniform positivity for S100 protein with both nuclear and cytoplasmic staining (100x, Immunostaining).
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S-100 protein immunostaining positivity (Fig. 4). Smooth muscle actin, desmin, calponin, caldesmon, CD117, DOG-1, HMB-45, and AE1/AE3 cytokeratins immunostaining was negative.