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case_images: Axial CT images showing a huge solid mass (red arrow ) in the pelvic cavity extended into the abdominal cavity.
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case_images: Computed Tomography (CT) revealed a solid mass, measuring up to 223 mm in the pelvic cavity and rectouterine pouch, which was extended into the right abdominal cavity, root of the mesentery and mesenteric vessels (Figure 1).
case_images: Sagittal MRI T2-weighted images showing a large T2 intense mass (red arrow ) in the pelvic cavity with extensions to the right upper quadrant of the abdomen and adhesions to the uterus fondus .
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case_images: Correspondingly, Magnetic Resonance Imaging (MRI) revealed a large T2 intense mass in the pelvic cavity, measuring up to 216 x 134 mm with extensions to the right upper quadrant of the abdomen with adhesions to the uterus fundus (Figure 2).
case_images: Fibrimyxoid area containing fusiform wavy cells admixed with inflammatory cells.
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case_images: Two expert pathologists reviewed the specimens, and the mass was diagnosed to be EIMS. involving the right ovary, uterus and peritoneum (Figure 3).
case_images: The anaplastic cells show strongly diffuse positivity for ALK and perinuclear accentuation of staining.
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case_images: Immunohistochemistry study (IHC) revealed positive staining for ALK (Figure 4).
case_images: SMA negative expression in neoplastic cells.
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case_images: Ki-67 proliferatin index was 30%, while no expression of Cluster of Differentiation (CD)34, Caldesmon, Desmin, Myogenic Differentiation 1 (MyoD1), CD117, cytokeratin, and smooth muscle actin (SMA) was detected (Figure 5).