PMC7877194_01
A pre-operative contrast enhanced abdominal CT scan axial section, shows a giant poli-lobulated mass occupying the pelvis.
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TC). The abdominal scan showed a mass of 18 x 17 x 12 cm (Fig. 1) with a double content: a solid part with a significant enhancement to the contrast and numerous pseudocystic images containing liquid.
A CT scan-based 3D reconstruction using Vesalius software for pre-operative planning. Color code: bone yellow, arterial red, vein light blue, orange brown, gall bladder violet, prosthate gland dark blue. A Mass and its relationship with vascular structures, right and left lateral view. B Cranial view. C Inferior vena cava congenital abnormality; the vein crosses the midline passing from right to left side. D Collateral left vein arising from inferior vena cava circulation due to compression of the tumour, running posteriorly to left iliac crest.
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It was located in meso and hypogastric and reached the pelvis in front of the rectum (Fig. 2).
Mildly atypical fused cell proliferation, organized in bundles, separated by abundant hyaline fibrous matrix, with CD-34 positive immune-phenotype. The proliferation index documented with the Ki-67 antibody was very low, absence of evident atypical mitosis (less than 4/10 HPF).
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The histopathological examination showed an extrathoracic solitary fibrous tumor with prevalent "hemangiopricytoma like" aspects with retroperitoneal localization (Fig. 3).
3 cm nodular lesion adherent to the left hypogastric internal artery.
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During the surgery we obtained multiple biopsies (Fig. 4).