PMC6081757_01
Lateral radiograph of the femur demonstrating a posterior thigh soft tissue shadow with internal calcifications.
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We obtained radiographs of the femur, which demonstrated a soft tissue shadow in the posterior thigh with some apparent calcifications within the mass (Figure 1).
T2-weighted axial MRI of the thigh demonstrating a large, posterior tumor which is enhancing, heterogeneous, and appears to abut the neurovascular structures.
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We then ordered a magnetic resonance imaging (MRI), which showed a large, heterogeneous soft tissue tumor abutting the neurovascular structures of the posterior thigh (Figures 2 and 3).
T2-weighted sagittal MRI of the thigh demonstrating a large, posterior thigh tumor which is enhancing and heterogeneous. Also note some proximally and distally tracking edema within the muscle.
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We then ordered a magnetic resonance imaging (MRI), which showed a large, heterogeneous soft tissue tumor abutting the neurovascular structures of the posterior thigh (Figures 2 and 3).
Clinical photograph of the tumor which was resected with a wide margin.
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The tumor was resected with a wide margin and sent for histopathologic evaluation (Figure 4).
Sections from the resection specimen show a proliferation of spindle cells with admixed large polygonal cells with abundant pale eosinophilic cytoplasm and pleomorphic nuclei. There was no obvious tumor necrosis and up to 10 mitotic figures were identified in 10 high-power fields.
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The morphologic and immunophenotypic features were consistent with an unclassified pleomorphic sarcoma with ectopic beta-hCG production (Figures 5 and 6).
By immunohistochemistry, there was strong staining of tumor cells for beta-hCG without staining for desmin, smooth muscle actin, S100 protein, SALL4, GATA3, cytokeratin, or CD34. The morphologic and immunophenotypic features were consistent with an unclassified pleomorphic sarcoma with ectopic beta-hCG production.
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The morphologic and immunophenotypic features were consistent with an unclassified pleomorphic sarcoma with ectopic beta-hCG production (Figures 5 and 6).