case_images: PMC10710107_01
case_images: (a) - Maximum intensity projection image (MIP) of the FDG PET-CT showing increased tracer uptake in the thoracic region right to the midline conforming to middle mediastinum mass on axial CT thorax section (b) with increased FDG uptake on fused PET-CT image (c). (d) - (g) - Axial CT lower thorax and abdomen region respectively with no abnormal FDG uptake on fused PET-CT images.
case_images: 10.1177_20363613231212380-fig1.jpg
case_images: PMC10710107_01_10.1177_20363613231212380-fig1.jpg
case_images: fig1-20363613231212380
case_images: In view of the possibility of malignancy, Positron emission tomography and computed tomography were done which revealed a large 12*9.8*9.8 cm heterogeneous mass (SUV max- 3.4) in the anterior mediastinum abutting the upper lobe of the right lung and pleural nodules in the area adjacent to mediastinum (SUV max-5.1) (Figure 1).
case_images: (a) Scantily spread cells among myxoidstroma showing positivity fordesmin (top left). (b) S-100 focal positivity seen in cells interspersed with myxoidstroma (top right). (c) High power view showing S-100 focally positive cells (bottom left). (d) Solid sheet like arrangement of pleomorphic cells which are CD34+ - characteristic of pleomorphic myxoidliposarcoma (bottom right).
case_images: 10.1177_20363613231212380-fig2.jpg
case_images: PMC10710107_01_10.1177_20363613231212380-fig2.jpg
case_images: fig2-20363613231212380
case_images: Response assessment done at the end of chemotherapy with Positron emission tomography revealed no residual disease (Figure 2).
case_images: (a) - MIP image of FDG PET-CT after surgery showing no abnormal FDG uptake in the middle mediastinum on axial CT images of thorax (b), lower thoracic region (d) and abdomen (f) and fused PET-CT images (c, e and g).
case_images: 10.1177_20363613231212380-fig3.jpg
case_images: PMC10710107_01_10.1177_20363613231212380-fig3.jpg
case_images: fig3-20363613231212380
case_images: After a treatment-free interval of 5 months, a follow-up PET-CT scan done revealed a 3.5*1.8 cm lesion in the posterior diaphragmatic crus (SUV max - 3.16) (Figure 3).
case_images: (a) - MIP image of the follow-up FDG PET-CT after 6 months of surgery showing faint area of radiotracer uptake in the upper abdomen region conforming to nodular lesions in the diaphragm (d) and (f), white arrows0 showing FDG uptake in the fused PET-CT images (e) and (g), white arrows).
case_images: 10.1177_20363613231212380-fig4.jpg
case_images: PMC10710107_01_10.1177_20363613231212380-fig4.jpg
case_images: fig4-20363613231212380
case_images: Histopathological examination of the surgical specimen revealed a high-grade pleomorphic myxoid liposarcoma (PLS) (Figure 4).
case_images: (a) - CT abdomen showing nodular lesions in the infra diaphragmatic surface. 1.2 x 1.8 cm on right side and 2.5 x 1.8 cm on left side. (b) - CT abdomen showing nodular lesions in the infradiaphragmatic surface measuring 0.8 x 1.0 cm on right side and 1.5 x 1.2 cm on left side showing mild, FDG uptake on fused PET-CT images (c).
case_images: 10.1177_20363613231212380-fig5.jpg
case_images: PMC10710107_01_10.1177_20363613231212380-fig5.jpg
case_images: fig5-20363613231212380
case_images: After 4 cycles of chemotherapy with eribulin, response assessment with a CT scan revealed a partial response (size reduced to 0.8*1.2 cms) and was planned to continue eribulin (Figure 5).