PMC6098845_01
Ultrasonography showing a 27 x 16 mm, irregular, low-echoic tumor (arrow). The tumor is located around the external iliac artery (a) and the external iliac vein (b).
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One year after the second surgery, a surveillance abdominal ultrasonography showed a 27 x 16 mm irregular and low-echoic tumor around the right external iliac artery (Figure 1).
Contrast-enhanced CT scan showing an irregular tumor around the right external iliac vessels and the small intestine, contiguous to the small intestine (arrow).
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These findings suggested tumor invasion to the right external iliac artery, the right external iliac vein, and the small intestine (Figure 2).
PET-CT showing intense tracer uptake (SUV max: 17.5) at the tumor (arrow).
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A PET/CT scan showed tracer uptake (standardized uptake value max: 17.5) at the tumor (Figure 3).
A femoro-femoral arterial bypass was performed, followed by an en bloc tumor resection. (a) The fixed solid tumor (*) at the right inguinal fossa. The tumor involved the external iliac artery, external iliac vein (arrowhead), ileum (arrow), and right obturator lymph nodes. The broken lines with blue color indicate the proximal and distal resection margins of the bowel. The broken lines with black-colored circle indicate the resection margin of the vessels. (b) Surgical specimen of the resection tumor (*) that invaded, including both the external iliac artery and vein (arrowhead) as well as the small intestine.
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En bloc tumor resection was successfully performed including a partial resection of the external iliac artery, external iliac vein, and ileum (Figure 4).