PMC9815857_01
Preoperative ultrasound findings. (A). Transabdominal ultrasound: cross-section view shows a heterogeneous echogenic mass and internal venous and low-resistance arterial blood flow spectrum. (B). Transvaginal ultrasound: longitudinal section of the uterus showing a posterior uterus in the center surrounded by heterogeneous echoes.
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Ultrasound, pelvic magnetic resonance imaging (MRI), and computed tomography (CT) revealed seroperitoneum and a complex mass measuring 15*14.7*11 cm anterior to the uterine fundus, suggestive of hemoperitoneum (probably originating from the rupture of a uterine mass) and sarcoma ( Figures 1 ,  2 ).
(A, B). In a 54-year-old woman, pelvic CT enhancement suggests clumpy soft-tissue foci with uneven internal enhancement and a central necrotic zone. (C-E). Pelvic magnetic resonance T2WI shows an uneven internal signal of the lesion and multiple small cysts inside the lesion. (F). The DWI sequence shows multiple flaky hyperinflections inside the lesion. (G, H). The enhancement sequence shows significantly uneven enhancement in the lesion and more pronounced peripheral intensification.
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Ultrasound, pelvic magnetic resonance imaging (MRI), and computed tomography (CT) revealed seroperitoneum and a complex mass measuring 15*14.7*11 cm anterior to the uterine fundus, suggestive of hemoperitoneum (probably originating from the rupture of a uterine mass) and sarcoma ( Figures 1 ,  2 ).
The same type of infiltrative tumor was found in both fallopian tubes, containing poorly differentiated adenosquamous cell carcinoma and undifferentiated sarcoma. (A). CK + (epithelial component) (EnVision, x100). (B). Vimentin+ (mesenchymal component) (EnVision, x100). (C). P40+ (squamous carcinoma component) (EnVision, x100). (D). The tumor consists of epithelial and mesenchymal components (H&E, x100). The mesenchymal component is an undifferentiated sarcoma with marked nuclear atypia (H&E, x100). (E). Tumor tissue has migrated with bilateral tubal mucosa (H&E, x100). (F). Adenocarcinoma carcinoma with marked nuclear atypia (H&E, x100).
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Figure 3 ). Postoperative diagnosis: stage IIIc MMMT of the fallopian tube. From
Changes in serum tumor markers.
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December 21, 2017, to March 29, 2018, the patient was treated with four cycles of intravenous chemotherapy based on carboplatin (500 mg) and paclitaxel (210 mg), with an interval of about one month. During chemotherapy, the CA125 returned to normal ( Figure 4 ), but the patient refused to continue chemotherapy because of bone marrow IV suppression.