PMC9618863_01
(A) Case 1 physical examination. (B) Gross pathologic examination revealed that the giant tumor was a grayish-white and grayish-yellow mass, measuring 15cmx9cmx9cm, and its capsule was intact. (C) The cut plane of the tumor was grayish white and grayish yellow. (D)Case 2 physical examination. (E) One grayish-red unshaped tissue measuring 9.5cmx5.5cmx4.2cm. (F) The cut plane of the tumor is partially grayish red jelly-like and partially grayish yellow soft in texture.
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CT: (A): CT shows heterogeneous isometric, low-mixed tissue mass foci in the scrotum. MRI: (B): The left testicle is visible in the T2 coronal position. (C): T2 coronal view shows tumor tissue (D): T2 axial view shows tumor parenchyma, and the testis squeezed to the bottom. (E): T2 axial view shows the testis. (F): T2 axial view shows the mass extending to the inguinal region. (G, H) T1 coronal view shows tumor NMR signal.
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(A) DDLPS micrographs showed that the tumor cells in the spindle cell sarcoma area were different in density, and some were arranged in a sclerosing myofibrosarcoma-like arrangement. (H & E, x200) (B) WDLPS micrographs show some atypical lipomatous areas with multinucleated tumor cells and multinucleated rosette-like cells; some are spindle cells and myxoid areas. (H & E, x200) (C) DDLPS MDM2 FISH: MDM2/CSP12: 8.58 MDM2 mean copy number: 20.60.
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The tumor cells in the area of spindle cell sarcoma were sparse and dense; some of them showed sclerotic myofibrosarcoma-like arrangement, scattered deeply stained mononuclear or multinucleated tumor cells, a prominent proliferation of interstitial collagen fibers or mucus-like changes, a large number of lymphocyte infiltration and lymphoid follicle formation; in some areas, the tumor cells were abundant, with apparent heterogeneity, visible rhabdomyosarcoma-like differentiation, nuclear division like 4~5/10 HPF, and focal pigment phagocyte aggregation( Figure 3A ).
Immunohistochemical staining of DDLPS, x100 (A): CDK4 (partial +), (B): Ki-67 (proliferation index about 25%), (C): Desmin (2+), Immunohistochemical staining of WDLPS, x100 (D): CDK4 (-) (E): KI 67 (30% +) (F): Desmin (+).
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Immunohistochemical staining of DDLPS, x100 (A): S-100 lipid component Immunohistochemical staining of WDLPS, x100 (B): CD34 (+) (C): P16 (+).
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PMC9618863_02
(A) Case 1 physical examination. (B) Gross pathologic examination revealed that the giant tumor was a grayish-white and grayish-yellow mass, measuring 15cmx9cmx9cm, and its capsule was intact. (C) The cut plane of the tumor was grayish white and grayish yellow. (D)Case 2 physical examination. (E) One grayish-red unshaped tissue measuring 9.5cmx5.5cmx4.2cm. (F) The cut plane of the tumor is partially grayish red jelly-like and partially grayish yellow soft in texture.
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Immunohistochemical staining of DDLPS, x100 (A): CDK4 (partial +), (B): Ki-67 (proliferation index about 25%), (C): Desmin (2+), Immunohistochemical staining of WDLPS, x100 (D): CDK4 (-) (E): KI 67 (30% +) (F): Desmin (+).
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Immunohistochemical staining of DDLPS, x100 (A): S-100 lipid component Immunohistochemical staining of WDLPS, x100 (B): CD34 (+) (C): P16 (+).
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Excision of the scrotal mass with the aid of scrotoscope.
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Scrotoscopic excision of the left scrotal mass was performed 6 days after admission ( Figure 6 ).