case_images: PMC11112093_01
case_images: PMC11112093_02
case_images: (A) Mixed echogenicity uterine tumor measuring 9.84 x 11.38 cm (transabdominal ultrasound). (B) Tumor with an active blood flow (transabdominal ultrasound).
case_images: fmed-11-1391978-g001.jpg
case_images: PMC11112093_02_fmed-11-1391978-g001.jpg
case_images: fig1
case_images: Transabdominal and transrectal sonoscopy was performed, revealing a large-sized mass in the pelvic area measuring 9.84 x 11.38 cm, displaying mixed echogenicity with active blood flow (likely uterine fibroid or sarcoma) (Figure 1).
case_images: (A) Right kidney AML 1.8 cm (2017). (B) Right kidney AML 2.3 cm (2022).
case_images: fmed-11-1391978-g002.jpg
case_images: PMC11112093_02_fmed-11-1391978-g002.jpg
case_images: fig2
case_images: The contrast was appropriately excreted by both kidneys, freely flowing into the bladder (Figure 2).
case_images: The tumor measured 10.0 x 11.5 x 12.2 cm, displacing surrounding structures but has not metastasized (2022 CT scan).
case_images: fmed-11-1391978-g003.jpg
case_images: PMC11112093_02_fmed-11-1391978-g003.jpg
case_images: fig3
case_images: In the right ovary, corpus luteum was visible along with several functional cysts up to 1.7 cm (Figure 3).
case_images: (A) Pathologic examination confirmed features of FH deficiency: hemangiopericytoma-like or "staghorn" vasculature. (B) At higher magnification, the nuclei are round-to-oval with prominent eosinophilic nucleoli, perinuclear clearing, and eosinophilic cytoplasmic globules. (C) Immunohistochemistry shows positive staining for smooth muscle actin. (D) Immunohistochemistry shows a loss of FH staining with retained expression in endothelial cells.
case_images: fmed-11-1391978-g004.jpg
case_images: PMC11112093_02_fmed-11-1391978-g004.jpg
case_images: fig4
case_images: Therefore, the final pathological diagnosis was leiomyoma with fumarate hydratase loss (Figure 4).