case_images: PMC9910815_01
case_images: Ultrasound images of the uterine intramural (A) and subserosal (B) masses show well-defined boundaries and similar echogenicity.
case_images: cureus-0015-00000033568-i01.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i01.jpg
case_images: FIG1
case_images: The radiologist diagnosed the three masses as uterine fibroids, and no further imaging was performed (Figure 1).
case_images: Gross image showing the uterine serosal surface with subserosal bulgings.
case_images: cureus-0015-00000033568-i02.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i02.jpg
case_images: FIG2
case_images: The subserosal masses had a homogeneous, white, firm, solid-cut surface (Figures 2, 3).
case_images: Gross image showing necrotic (short arrow) and hemorrhagic (long arrow) cut surface of tumor in the uterine cavity.
case_images: cureus-0015-00000033568-i03.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i03.jpg
case_images: FIG3
case_images: The subserosal masses had a homogeneous, white, firm, solid-cut surface (Figures 2, 3).
case_images: Hematoxylin and eosin stain of the tumor. Low-power view showing myxoid tumor infiltrating the myometrium.
case_images: cureus-0015-00000033568-i04.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i04.jpg
case_images: FIG4
case_images: Necrosis was present, and mitosis was minimal at around 2 per 10 high-power fields (Figures 4-6).
case_images: Hematoxylin and eosin stain of the myxoid tumor. 40x magnification of the bland spindle tumor cells (arrows) admixed with inflammatory cells in a myxoid background.
case_images: cureus-0015-00000033568-i05.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i05.jpg
case_images: FIG5
case_images: Necrosis was present, and mitosis was minimal at around 2 per 10 high-power fields (Figures 4-6).
case_images: Hematoxylin and eosin stain of the uterine inflammatory myofibroblastic tumor (IMT). 40x magnification demonstrating plasma cells (arrows) and mitosis (arrowhead).
case_images: cureus-0015-00000033568-i06.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i06.jpg
case_images: FIG6
case_images: Necrosis was present, and mitosis was minimal at around 2 per 10 high-power fields (Figures 4-6).
case_images: Vascular invasion of the inflammatory myofibroblastic tumor (IMT) is well-demonstrated in hematoxylin and eosin stain.
case_images: cureus-0015-00000033568-i07.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i07.jpg
case_images: FIG7
case_images: Additionally, extensive vascular invasion was revealed by CD31 and CD34 immunohistochemical stains (Figures 7, 8).
case_images: CD34 stain highlighting the vascular invasion.
case_images: cureus-0015-00000033568-i08.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i08.jpg
case_images: FIG8
case_images: Additionally, extensive vascular invasion was revealed by CD31 and CD34 immunohistochemical stains (Figures 7, 8).
case_images: Immunohistochemical stain. The tumor cells are positive for anaplastic lymphoma kinase (ALK).
case_images: cureus-0015-00000033568-i09.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i09.jpg
case_images: FIG9
case_images: The tumor cells showed granular cytoplasmic positivity to anaplastic lymphoma kinase (ALK) and focal positivity to desmin and smooth muscle actin, whereas they were negative for caldesmon, estrogen receptor, P16, CD10, and cyclin D1 (Figures 9-11).
case_images: Immunohistochemical stain. The tumor cells are focally positive for desmin.
case_images: cureus-0015-00000033568-i10.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i10.jpg
case_images: FIG10
case_images: The tumor cells showed granular cytoplasmic positivity to anaplastic lymphoma kinase (ALK) and focal positivity to desmin and smooth muscle actin, whereas they were negative for caldesmon, estrogen receptor, P16, CD10, and cyclin D1 (Figures 9-11).
case_images: Immunohistochemical stain. Estrogen receptor (ER) is negative in the tumor cells.
case_images: cureus-0015-00000033568-i11.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i11.jpg
case_images: FIG11
case_images: The tumor cells showed granular cytoplasmic positivity to anaplastic lymphoma kinase (ALK) and focal positivity to desmin and smooth muscle actin, whereas they were negative for caldesmon, estrogen receptor, P16, CD10, and cyclin D1 (Figures 9-11).
case_images: Hematoxylin and eosin stain of the subserosal leiomyoma with hyalinization (asterisks) and calcification (arrows).
case_images: cureus-0015-00000033568-i12.jpg
case_images: PMC9910815_01_cureus-0015-00000033568-i12.jpg
case_images: FIG12
case_images: The subserosal masses showed classic leiomyomata with hyalinization and dystrophic calcification (Figure 12).