case_images: PMC4783561_01
case_images: The patient had varices (a) and a port-wine stain (capillary malformation) on the left leg (b).
case_images: CRIOG2016-4328450.001.jpg
case_images: PMC4783561_01_CRIOG2016-4328450.001.jpg
case_images: fig1
case_images: She had varices and a port-wine stain (capillary malformation) on the left leg (Figure 1), and at the age of 15, she had undergone tibial epiphyseal line suppression surgery because of right foot hypertrophy.
case_images: Ultrasonography demonstrated tubular echolucent spaces throughout the myometrium (a), and color Doppler showed blood flow within some of the cystic lesions (b) at 27 weeks of gestation.
case_images: CRIOG2016-4328450.002.jpg
case_images: PMC4783561_01_CRIOG2016-4328450.002.jpg
case_images: fig2
case_images: At 27 weeks of gestation, ultrasonography demonstrated tubular echolucent spaces throughout the myometrium (Figure 2(a)), and color Doppler showed blood flow within some of the cystic lesions (Figure 2(b)).
case_images: T2-weighted MRI showed a greatly enlarged uterus and diffuse myometrial thickening with a visible junctional zone between the endometrium and large high-intensity myometrium at 30 weeks of gestation ((a) transverse plane and (b) coronal plane).
case_images: CRIOG2016-4328450.003.jpg
case_images: PMC4783561_01_CRIOG2016-4328450.003.jpg
case_images: fig3
case_images: T2-weighted magnetic resonance imaging (MRI) showed a greatly enlarged uterus and diffuse myometrial thickening with a visible junctional zone between the endometrium and large high-intensity myometrium at 30 weeks of gestation, (Figures 3(a) and 3(b)).
case_images: Dynamic contrast-enhanced-MRI using gadolinium at 37 weeks of gestation revealed that the myometrial lesion was enhanced slowly and showed homogeneous enhancement even on a 10 min delayed image, whereas the placenta demonstrated marked arterial enhancement and subsequent rapid washout.
case_images: CRIOG2016-4328450.004.jpg
case_images: PMC4783561_01_CRIOG2016-4328450.004.jpg
case_images: fig4
case_images: DCE-MRI revealed that the myometrial lesion was enhanced slowly and showed homogeneous enhancement even on a 10 min delayed image, whereas the placenta demonstrated marked arterial enhancement and subsequent rapid washout (Figure 4).
case_images: Histological examination showed numerous, variably sized, and thin-walled vessels distributed throughout the myometrium. The endothelial lining on the vessel wall was confirmed by strong immunoreactivity for CD31 and CD34, and lack of elastic fiber layer was observed by immunostaining with Elastica van Gieson.
case_images: CRIOG2016-4328450.005.jpg
case_images: PMC4783561_01_CRIOG2016-4328450.005.jpg
case_images: fig5
case_images: The endothelial lining on the vessel wall was confirmed by strong immunoreactivity for CD31 and CD34, and lack of elastic fiber layer was observed by immunostaining with Elastica van Gieson (Figure 5).