case_images: PMC4718252_01
case_images: CT findings of the tumor in 2007. (A) CT showed a classical triangle soft tissue density shadow in the pelvic cavity; maximum cross-section was ~5.5 x 2.5 cm. Lesions border was clear; its signal was well-distributed. Double side basin wall and inguinal region did not see obvious swelling lymph nodes; CT findings of the tumor at the second recurrence in 2009. (B) CT showed an irregular soft tissue mass shadow in the pelvic cavity. Lesions border was not clear. Local and right side of the bladder wall had not clear boundaries. CT = computed tomography.
case_images: medi-95-e2433-g001.jpg
case_images: PMC4718252_01_medi-95-e2433-g001.jpg
case_images: F1
case_images: Computed tomography (CT) scan revealed a mass (5.5 cm in the longest diameter) in the cavity of the pelvic, the lesions border was clear, and no obvious swelling lymph nodes in double side basin wall and inguinal region (Figure 1A). Pelvic CT revealed a tumor of ~7.5 cm in diameter, mixed density showing multiple soft tissue mass (Figure 1B).
case_images: Histopathological findings of the primary tumor excised in 2007. (A) Spindle or oval cells with mild to moderate nuclear atypia, which shows a so-called patternless pattern (a: HE x 100). Immunohistochemical findings in 2007. (B) The specimen was positive for CD34.
case_images: medi-95-e2433-g002.jpg
case_images: PMC4718252_01_medi-95-e2433-g002.jpg
case_images: F2
case_images: Pathologically, the tumor contained predominantly oval or spindle cells organized in a haphazard growth pattern (a so-called patternless pattern) (Figure 2A). Immunohistochemical stains revealed positive expression for CD34 (Figure 2B), Bcl-2, Ki-67, and Vimentin.
case_images: Histopathological findings of the tumor at the second recurrence in 2009. (A) Histologic evidence to support malignant transformation in solitary fibrous tumor of pelvic includes high cellularity with pleomorphism and increased mitosis, HE x 100. Immunohistochemical findings in 2009. (B) The specimen was positive for CD34. (C) The specimen was positive for Bcl-2.
case_images: medi-95-e2433-g003.jpg
case_images: PMC4718252_01_medi-95-e2433-g003.jpg
case_images: F3
case_images: Postoperative pathology showed spindle cell tumor with hemorrhage and necrosis, and tumor cells had a certain degree of nuclear atypia, high mitotic activity (Figure 3A). CD34 (Figure 3B), Bcl-2 (Figure 3C), CD99, and vimentin, but negative for S-100, SMA, and CD117. Combining with the medical history, it was considered as malignant SFT.