case_images: PMC4158327_01
case_images: ((a) and (b)) Permeative pattern in distal femur; (c) malignant looking lesion is corroborated with a MRI. MRI: magnetic resonance imaging.
case_images: CRIS2014-439061.001.jpg
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case_images: fig1
case_images: The physical examination revealed increased volume of the knee, tenderness, and edema, the X-ray showed a permeative pattern in distal femur (Figures 1(a) and 1(b)) without evidence of fracture; the malignant-looking lesion was corroborated with a MRI (Figure 1(c)).
case_images: Pulmonary nodules (arrows) in both hemithoraces on a CT scan.
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case_images: fig2
case_images: The evidence of pulmonary nodules (smaller than 1 cm) in CT scan suggested metastatic disease in both hemithoraces (Figure 2).
case_images: CT scan 3 months later reported multiple pulmonary nodules (arrows) that remain in number and dimension in relation to the previous CT.
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case_images: fig3
case_images: Months later a CT scan demonstrated that pulmonary nodules remained in number and dimensions in relation to the previous CT scan (Figure 3).
case_images: Nonanatomic pulmonary resection of superior and inferior left lobe was performed by posterolateral thoracotomy.
case_images: CRIS2014-439061.004.jpg
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case_images: fig4
case_images: Through posterolateral thoracotomy a nonanatomic pulmonary segment resection of right superior and inferior lobes with 60 mm blue cartridge GIA stapler (Covidien Surgical, Norwalk, CT, USA) was performed (Figure 4); the transoperatory biopsy described a white nodular lesion of approximately 1 cm extension with benign pattern.
case_images: Fibromuscular tissue growth with nonneoplastic ossification; immunohistochemistry nodules composed of cells, vimentin, AML, calponin, ALK1, a240, D, and Ki67 20%. AML: actina de musculo liso (smooth muscle actin).
case_images: CRIS2014-439061.005.jpg
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case_images: fig5
case_images: The final pathology report described benign fibromuscular proliferative lesions, cells forming nodes, by immunohistochemistry, vimentin, AML, calponin, ALK1, d240, re, and 20% of Ki67, (Figure 5) consistent with benign metastasizing leiomyoma, which was corroborated by three uterine myomas in a pelvic US (Figure 6).
case_images: Pelvic US shows uterine myoma in posterior wall of 30 x 25 x 20 mm. Two myomas in the interior wall.
case_images: CRIS2014-439061.006.jpg
case_images: PMC4158327_01_CRIS2014-439061.006.jpg
case_images: fig6
case_images: The final pathology report described benign fibromuscular proliferative lesions, cells forming nodes, by immunohistochemistry, vimentin, AML, calponin, ALK1, d240, re, and 20% of Ki67, (Figure 5) consistent with benign metastasizing leiomyoma, which was corroborated by three uterine myomas in a pelvic US (Figure 6).