case_images: PMC4659703_01
case_images: Initial presentation with massive swelling of right hand with involvement of hemithorax.
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case_images: PMC4659703_01_can-9-590fig1.jpg
case_images: figure1
case_images: As time progressed, so did the swelling with extension from her hand to shoulder with eventual involvement of her right chest wall and hemithorax (Figure 1).
case_images: Axial CT chest demonstrating swelling of right hemithorax.
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case_images: PMC4659703_01_can-9-590fig2.jpg
case_images: figure2
case_images: A computed tomography (CT) scan of the chest with contrast revealed soft tissue oedema without evidence of thrombus or obstruction in the venous system (Figure 2).
case_images: Pathology at 10x magnification showing a nodular, neoplastic proliferation composed of small ovoid to spindled cells demonstrating relatively bland, monomorphic nuclei and located within a variable fibrous to myxoid stroma.
case_images: can-9-590fig3.jpg
case_images: PMC4659703_01_can-9-590fig3.jpg
case_images: figure3
case_images: Immunohistochemically, the tumour cells involved were positive for epithelial membrane antigen and progesterone receptor but negative for Ewing sarcoma break point 1 gene translocation, smooth muscle antigen, cytokeratin AE1/AE3, S100, calretinin, microphthalmia-associated transcription factor (MITF), and claudin 1 (Figure 3).
case_images: Improvement in swelling after 1 cycle of chemotherapy.
case_images: can-9-590fig4.jpg
case_images: PMC4659703_01_can-9-590fig4.jpg
case_images: figure4
case_images: After one cycle of chemotherapy, she had a drastic improvement in her symptoms and physical appearance (Figure 4).