case_images: PMC11100375_01
case_images: Axial (A) and sagittal (B) T2 MRI images demonstrating a pedunculated, multi-lobulated, multiseptated T2 hyperintense heterogeneously enhancing mass arising from the left proximal medial thigh. Clinical image of patient (C).
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case_images: PMC11100375_01_10.1177_20363613241255668-fig1.jpg
case_images: fig1-20363613241255668
case_images: T2 hyperintense heterogeneously enhancing mass arising from the left proximal thigh (Figure 1), measuring 26 x 23 x 36 cm in close proximity to the femoral vessels. These findings suggested the possibility of a large soft tissue sarcoma.
case_images: Preoperative image demonstrating pedicled nature of sarcoma (A). Intraoperative image demonstrating soft tissue defect with vascular repair (B). The cross section shows multilobulated pink tan to yellow, fleshy cut surface (C).
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case_images: Second, after a discussion with her medical oncologist, it was determined pretreatment, while beneficial in tumor reduction, would not substantially reduce the narrow communicating stalk (Figure 2(A)). Vascular surgery performed their reconstruction at that point (Figure 2(B)) followed by plastic surgical reconstruction of the soft tissue defect. Sectioning through the mass showed a multilocular mass with heterogenous appearance (Figure 2(C)) ranging from smooth, flesh-tan to yellow-tan with focal areas of hemorrhage.
case_images: Low cellular areas with spindled to stellate cells with scarce mitotic activity (A) and areas with pools of mucin are appreciated, resembling pulmonary edema-like pattern (B). Multivacuolated lipoblasts are present. Mild nuclear pleomorphism is appreciated (C). Focal hypercellular area composed of small round blue cells comprising 5% of the tumor (D).
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case_images: fig3-20363613241255668
case_images: The tumor showed a predominant growth of classic morphology consisting of stellate cells with scarce mitotic activity in branching vascular network (Figure 3(A)). There were areas containing mucin pools representing pulmonary edema-like pattern (Figure 3(B)) and some areas of multivacuolated lipoblasts (Figure 3(C)). There was an area of hypercellularity composed of small round blue cells consistent with high-grade myxoid liposarcoma comprising 5% of the tumor (Figure 3(D)).