PMC2713850_01
A 47-year-old man with retroperitoneal malignant mesenchymoma.. A. Plain abdominal radiograph demonstrates a large mass with multiple, dense, large, stippled calcifications in the left-side abdomen.. B. Contrast-enhanced abdominal CT scan at the renal level depicts a large conglomerate mass with densely calcified nodules, shown at histopathologic correlation to be consistent with osteosarcoma, in the left-side reteroperitoneum. The mass invades the left kidney (arrows).. C. Contrast-enhanced abdominal CT scan, caudal to that seen in (B), depicts lobulated non-calcified soft tissue nodules (arrows) with strong peripheral enhancement and, in some areas, central low attenuation. The nodules correspond to leiomyosarcoma, liposarcoma, and fibrosarcoma.. D. Microscopically, the osteosarcomatous component consists of a central malignant osteoid within a background of malignant spindle cells (original magnification, x100; hematoxylin-eosin staining).. E. Microscopically, the leiomyosarcomatous component contains typical blunt-ended nuclei with mitotic configuration (original magnification, x100; hematoxylin-eosin staining).. F. Microscopically, the liposarcomatous component contains occasional scattered lipoblasts between fat cells (original magnification, x100; hematoxylin-eosin staining).
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F1
His laboratory data were normal, but plain radiography of the abdomen showed that in the left upper quadrant, a huge mass with exuberant calcifications was present (Fig. 1A). The upper portion of the mass showed dense or stippled calcifications (Fig. 1B), whereas in the lower portion there were several non-calcified soft tissue nodules with strong peripheral enhancement and a central necrotic area (Fig. 1C). Microscopically, the nodule around the dense calcification was consistent with osteosarcoma (Fig. 1D), and the soft tissue nodules in the lower part corresponded to leiomyosarcoma (Fig. 1E), liposarcoma (Fig. 1F), and fibrosarcoma.