case_images: PMC4560135_01
case_images: PMC4560135_02
case_images: Physical findings on initial examination. The tumor in the left axilla was fist-sized, solid, and immovable. A scar from a biopsy incision overlay the tumor
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case_images: PMC4560135_02_40792_2015_65_Fig1_HTML.jpg
case_images: Fig1
case_images: Examinations: Physical findings on initial examination included an elastic, hard, fist-sized tumor in the left axilla; the tumor was solid and immovable (Fig. 1).
case_images: Contrast-enhanced chest computed tomography. The tumor in the left axilla measured 11 cm x 7 cm x 11 cm. It had a relatively distinct border, but its surface was irregular
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case_images: PMC4560135_02_40792_2015_65_Fig2_HTML.jpg
case_images: Fig2
case_images: Contrast-enhanced chest computed tomography showed a tumor measuring 11 cm x 7 cm x 11 cm, with relatively distinct borders, but irregular surfaces (Fig. 2).
case_images: Histopathological biopsy findings. a Hematoxylin-and-eosin staining (high-power field). Atypical epithelial cells with spindle-shaped nuclei and rich cytoplasm were present in dense sheets. b S-100 staining. The tumor was strongly and diffusely positive for S-100 protein
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case_images: PMC4560135_02_40792_2015_65_Fig3_HTML.jpg
case_images: Fig3
case_images: Histology: Histopathological examination of a biopsy specimen showed densely sheathed atypical epithelial cells with spindle-shaped nuclei and rich cytoplasm (Fig. 3a). The tumor was strongly and diffusely positive for vimentin, S-100 protein (Fig. 3b), and neuron-specific enolase, a pattern of immunoreactivity differing from that of conventional MPNST.
case_images: PMC4560135_03
case_images: PMC4560135_04
case_images: PMC4560135_05
case_images: Pathological autopsy. Metastatic tumor cells were found in the peritoneum, lymph nodes, pharynx, pleura, lungs, pericardium, endocardium, myocardium, liver, omentum, pancreas, splenic hilum, stomach, jejunum, ileum, transverse colon, appendix, and bone marrow. Informed consent to publish this photograph was obtained from the patient before death and from the patient's family after death
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case_images: PMC4560135_05_40792_2015_65_Fig4_HTML.jpg
case_images: Fig4
case_images: Pathology at autopsy (Fig. 4): An autopsy was performed 24 h after death.