case_images: PMC4406529_01
case_images: Ultrasonography of whole abdomen and pelvis showed a large mass occupying whole of pelvis just superior to fundus of uterus (not arising from the uterus).
case_images: can-9-524fig1.jpg
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case_images: figure1
case_images: There was also moderate free fluid seen in the peritoneal cavity with moving internal echoes (Figure 1a-b).
case_images: Chest x-ray PA digital view did not reveal any major abnormalities except for marginal increase of cardiac size in transverse diameter.
case_images: can-9-524fig2.jpg
case_images: PMC4406529_01_can-9-524fig2.jpg
case_images: figure2
case_images: The chest x-ray did not reveal any major abnormalities except for marginal increase of cardiac size in transverse diameter without any clinical cardiac abnormalities (Figure 2).
case_images: MRI of pelvis (coronal, sagittal, and transverse view) shows large oval well-defined mass lesion occupying whole of pelvis just superior to fundus of uterus (not arising from the uterus indicated by arrow mark).
case_images: can-9-524fig3.jpg
case_images: PMC4406529_01_can-9-524fig3.jpg
case_images: figure3
case_images: On the basis of these findings, a provisional diagnosis of leiomyoma, possibly pedunculated, was made (Figure 3a-c).
case_images: Cut section of right ovary specimen shows variegated appearance with focal areas of hemorrhage.
case_images: can-9-524fig4.jpg
case_images: PMC4406529_01_can-9-524fig4.jpg
case_images: figure4
case_images: The patient underwent laparotomy followed by right salpingo-oophorectomy and peritoneal lavage with perioperative findings revealing 15 cm x 15 cm ovarian mass with clotted blood (Figure 4a-b), areas of hemorrhage, and necrosis.
case_images: Photomicrograph showing oval to spindle cells with mild to moderate pleomorphism and high mitotic activity, H & E stain (200X).
case_images: can-9-524fig5.jpg
case_images: PMC4406529_01_can-9-524fig5.jpg
case_images: figure5
case_images: Finally the patient was diagnosed as primary leiomyosarcoma of right ovary based on histopathological examination and immunohistochemistry (Figure 5).
case_images: Photomicrograph showing tumour cells showing SMA positivity (200X).
case_images: can-9-524fig6a.jpg
case_images: PMC4406529_01_can-9-524fig6a.jpg
case_images: figure6a
case_images: Immunohistochemistry of the tissue revealed positive for vimentin (Figure 6b), smooth muscle actin (Figure 6a), desmin, and it was negative for inhibin.
case_images: Photomicrograph showing tumour cells showing vimentin positivity (20X).
case_images: can-9-524fig6b.jpg
case_images: PMC4406529_01_can-9-524fig6b.jpg
case_images: figure6b
case_images: Six months after the treatment completion, the patient is on regular follow-up and is disease-free on clinical and radiological examination (Figure 7a-c).