case_images: PMC9996247_01
case_images: Other imaging results. a A small bowel series showed no significant findings. b Retrograde balloon-assisted enteroscopy (BAE) showed no irregularity of the bowel wall. The tumor itself was undetectable via endoscopy. c On EUS, we detected a tumor with blood flow and low echoic lesions within it on the medial side of the bladder. The tumor was not attached to the small intestine, colon, or bladder, and there was no apparent tumor invasion.
case_images: crg-2022-0017-0001-529340_f1.jpg
case_images: PMC9996247_01_crg-2022-0017-0001-529340_f1.jpg
case_images: F1
case_images: Fig. 1a). A small bowel series showed no significant findings (Fig. 1a). However, there was no irregularity of the bowel wall (Fig. 1b), and we performed ink-jet marking at the end-point. We detected a tumor with blood flow and low echoic lesions within it on the medial side of the bladder (Fig. 1c).
case_images: a A fist-sized dark red tumor measuring 7.0 x 4.0 x 6.5 cm was identified on the caudal side of the endoscopic marking on the pelvic diaphragm with phyllodes growth outside the small intestine. b On the cranial side of this tumor, multiple grain-sized (approx. 2.5 mm) extramural nodules were observed.
case_images: crg-2022-0017-0001-529340_f2.jpg
case_images: PMC9996247_01_crg-2022-0017-0001-529340_f2.jpg
case_images: F2
case_images: Fig. 2a). Fig. 2b). Fig. 2c). A fist-sized dark red tumor measuring 7.0 x 4.0 x 6.5 cm was found on the caudal side of the endoscopic marking on the pelvic diaphragm with phyllodes growth outside the small intestine (Fig. 2a). On the cranial side of this tumor, multiple grain-sized (approx. 2.5 mm) extramural nodules were found (Fig. 2b).
case_images: Microscopic findings of the tumor. a Spindle-shaped cells arranged in bundles. a' Hematoxylin-eosin stain of the nodules. b Large areas of hemorrhage and necrosis. c Cell protein Ki-67 analysis of the tumor. c' Ki-67 analysis of the nodule. d The tumor was c-KIT positive. d' The nodule was also c-KIT positive. d'' Negative control of c-KIT staining. e S-100 analysis of the tumor. e' S-100 analysis of the nodules.
case_images: crg-2022-0017-0001-529340_f3.jpg
case_images: PMC9996247_01_crg-2022-0017-0001-529340_f3.jpg
case_images: F3
case_images: Microscopically, the tumor consisted of spindle-shaped cells arranged in bundles (Fig. 3a). Large areas of hemorrhage and necrosis were identified (Fig. 3b). Immunohistochemical analysis revealed that the Ki-67 index was 5% (Fig. 3c, c'). Both the tumor and the surrounding nodules were positive for c-KIT (Fig. 3d, d').