case_images: PMC10757060_01
case_images: PMC10757060_02
case_images: Contrast-enhanced computed tomography (CT) revealing an 8 x 7 x 12cm3 mass lesion in the left retroperitoneal space ( ). Dynamic CT revealing high-contrast enhancement in the arterial phase and washout in the delayed phase
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case_images: F1
case_images: Dynamic CT study showed high-contrast enhancement in the arterial phase and washout in the late phase (Figure 1).
case_images: Magnetic resonance imaging showing low-signal lesions on T1-weighted imaging (T1WI) and high-signal lesions on T2-weighted imaging (T2WI). A signal change in the center of the lesion suggested degeneration or necrosis can be observed. Fat-suppressed T1WI (FST1WI) revealing a faint high-signal area within the lesion ( ):a finding suspicious for internal haemorrhage. FST2WI, fat-suppressed T2WI
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case_images: F2
case_images: Fat-suppressed T1-weighted images showed a faint high-signal area within the lesion, which was indicating the internal hemorrhage (Figure 2).
case_images: 123I-MIBG scintigraphy revealing only one abnormal accumulation consistent with the retroperitoneal lesion ( ). 123I-MIBG accumulation is shown only in part of the retroperitoneal lesion. SPECT/CT, single photon emission CT/CT
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case_images: F3
case_images: 18F-FDG positron emission tomography/computed tomography (PET/CT) showing intense FDG uptake (maximum standardized uptake value [SUVmax], 38) in the retroperitoneal lesion ( , 18F-FDG MIP image and fused PET/CT). FDG uptake in a small nodule at the base of the lower lobe of the right lung (SUVmax, 9.8) is also observed ( , 18F-FDG MIP image and fused PET/lung window CT). MIP, maximum intensity projection
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case_images: F4
case_images: In addition, a small nodule-like FDG uptake was found at the base of the lower lobe of the right lung (SUVmax=9.8) (Figure 4).
case_images: Contrast-enhanced CT showing a 0.7 x 0.5 x 0.7cm3 nodule in the right lung base that is strongly contrasted in the arterial phase and washed out in the delayed phase ( )
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case_images: F5
case_images: By reviewing the contrast-enhanced dynamic CT, a 0.7x0.5x0.7 cm3 nodule was found at the base of the lower lobe of the right lung presenting high contrast-enahncement in the arterial phase and washed out in the late phase (Figure 5); this led us to suspect pulmonary metastasis of PG.
case_images: Split surface of the resected lesion showing brownish color upon gross examination. Histologically, the lesion comprised large polygonal cells with abundant cytoplasm. Abundant intervening blood vessels surrounded the cell cords and cytoplasm. The nuclei of the component cells are enlarged and irregular in shape. Immunostaining showing positive for chromogranin A and partially positive for S100; the MIB-1 index is 26.6%. HE, hematoxylin and eosin
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case_images: F6
case_images: Immunostaining was positive for chromogranin A and partially positive for S100; the MIB-1 labeling index was 26.6% (Figure 6).
case_images: PMC10757060_03