PMC8339337_01
(A and B): Chest X-Ray showing bilateral pulmonary nodules. (A) The new film upon presentation. (B) 2-years before.
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Chest X-Ray showed bilateral multiple rounded balloon-like opacities, a finding described two years ago on chest x-ray film but was not investigated (Fig. 1A and B).
(A, B, and C): (2 A) Computerized Tomographic chest film confirming bilateral rounded pulmonary nodules. (2 B) MRI pelvis showing the penile shaft basal tumor (Highlighted by the white arrow). (2 C) Coronal PET-CT confirming the penile uptake (Highlighted by the white arrow).
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A CT scan chest with contrast confirmed the findings of bilateral wide-spread rounded lung lesions of 5-30 mm in diameter (Fig. 2A). PET-CT demonstrated mild FDG uptake in the pulmonary nodules and the pelvic region (Fig. 2C). MRI pelvis revealed an infiltrative penile shaft base lesion involving the corpora spongiosum (Fig. 2B), a biopsy that showed myxoid sarcoma compatible with extraskeletal chondrosarcoma.
Lung nodule biopsy showing tumoral proliferation of spindle to stellate-shaped cells forming anastomosing cords and lobules within the myxoid stroma. Vimentin is diffusely positive, and p63 shows patchy positivity. S100 shows focal positivity.
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The lung nodule's CT-guided biopsy confirmed a myxoid mesenchymal neoplasm and showing tumoral proliferation of spindle to stellate-shaped cells forming anastomosing cords and lobules within the myxoid stroma (Fig. 3A). Vimentin is diffusely positive, and p63 shows patchy positivity with EWSR1 rearrangement on Fluorescence in Situ Hybridization (FISH) study. (Fig. 3B).