case_images: PMC11707774_01
case_images: (a) STIR-weighted coronal image showing the voluminous thigh mass with irregular borders and heterogeneous high signal. (b) Enhanced T1WI coronal image showing peripheral enhancement of the voluminous thigh mass with central necrosis.
case_images: 10.1177_20584601241313111-fig1.jpg
case_images: PMC11707774_01_10.1177_20584601241313111-fig1.jpg
case_images: fig1-20584601241313111
case_images: Thigh MRI revealed a voluminous mass of the right thigh (Fig 1(a)-(b)), occupying almost the entire quadricipital space.
case_images: Histological appearance at medium magnification (x20) showing a largely necrotic, pleomorphic, and hyperchromatic sarcomatous proliferation. The immunohistochemical results are consistent with a pleomorphic rhabdomyosarcoma grade 3 according to the FNCLCC classification.
case_images: 10.1177_20584601241313111-fig2.jpg
case_images: PMC11707774_01_10.1177_20584601241313111-fig2.jpg
case_images: fig2-20584601241313111
case_images: T2WI, and an irregular peripheral enhancement. The mass invades the upper 1/3 of the femur and the various chiefs of the quadriceps muscle. The thigh mass was biopsied and revealed a soft tissue sarcoma (Fig 2).
case_images: Axial enhanced CT image displaying a cystic myocardial mass, which enhances after contrast injection and appears to be attached to the left ventricle, consistent with a cardiac metastasis.
case_images: 10.1177_20584601241313111-fig3.jpg
case_images: PMC11707774_01_10.1177_20584601241313111-fig3.jpg
case_images: fig3-20584601241313111
case_images: The mass, measuring 57 x 34 mm, appeared to be attached to the left ventricle and was consistent with a cardiac metastasis (Fig 3).
case_images: (a) Axial CT image showing hepatic metastasis and muscular paravertebral metastasis. (b) Axial CT image with lung window and maximal intensity projection (MIP) showing multiple pulmonary metastasis.
case_images: 10.1177_20584601241313111-fig4.jpg
case_images: PMC11707774_01_10.1177_20584601241313111-fig4.jpg
case_images: fig4-20584601241313111
case_images: CT also revealed the presence of other secondary localizations in the lungs, liver, lymph nodes, spleen, bone, and right paravertebral muscles with intramedullary invasion (Fig 4(a)-(b)).