case_images: PMC9240338_01
case_images: (a) Gross aspect of ULMS: enlarged and deformed uterus by a nodular lesion with a
  maximum diameter of 28 cm. (b) Microscopical features of the cytological exam: round or
  fusiform malignant cells, isolated or grouped in clusters; in case: a giant
  multinucleated cell (Giemsa stain; Ob x100; in case Ob x200). (c) Microscopical features
  of ULMS: hypercellular and fusiform proliferation of highly mitotic, pleomorphic
  malignant cells (HE stain, Ob x100).
case_images: 10.1177_2632010X221105224-fig1.jpg
case_images: PMC9240338_01_10.1177_2632010X221105224-fig1.jpg
case_images: fig1-2632010X221105224
case_images: The cytological evaluation identified isolated or clustered malignant cells, round or spindle-shaped, highly suggestive for sarcoma (Figure 1b). On cut surface, this was fleshy, fasciculated, with cystic spaces, necrosis and hemorrhage (Figure 1a). Microscopically, the tumor was composed of a dense malignant cell population with fusiform appearance, moderate to severe cytological pleomorphism and an important mitotic activity (12 mitoses/10 high power fields) (Figure 1c).
case_images: (a) Ki-67: intense, diffuse nuclear expression in more than 50% of the tumor nuclei
  (Immunohistochemical stain, Ob x100). (b) p16: intense, diffuse nuclear expression in
  more than 75% of the tumor nuclei (Immunohistochemical stain, Ob x100). (c) p53:
  intense, diffuse nuclear expression in more than 80% of the tumor nuclei
  (Immunohistochemical stain, Ob x100).
case_images: 10.1177_2632010X221105224-fig2.jpg
case_images: PMC9240338_01_10.1177_2632010X221105224-fig2.jpg
case_images: fig2-2632010X221105224
case_images: Negative immunoexpression for Estrogen (ER) and Progesteron receptor (PR) was noticed, as well as weak focal reaction for Smooth Muscle Actin (SMA) and Desmin (Figure 2).