case_images: PMC7397415_01
case_images: Frontal (a) and lateral (b) view of the large protruding tumor (arrow) located on the abdominal wall. The lesion measured 3 x 3 x 2 cm at the first visit. A keloid scar (arrowhead) is visible on the abdominal wall due to partial resection of endometrial cancer. Axial (c) and sagittal (d) view of magnetic resonance imaging revealing a tumor protruding subcutaneously with no continuity to the abdominal cavity (arrow).
case_images: CRIDM2020-4898965.001.jpg
case_images: PMC7397415_01_CRIDM2020-4898965.001.jpg
case_images: fig1
case_images: On physical examination, a protruding lesion continuous with the keloid scar was noted on the abdominal wall, measuring approximately 3 x 3 x 2 cm (Figures 1(a)-1(b)). Furthermore, magnetic resonance imaging (MRI) 1 week later revealed a tumor measuring 5 x 4 x 3 cm protruding subcutaneously with no continuity to the abdominal cavity (Figures 1(c)-1(d)).
case_images: Frontal (a) and lateral (b) view of the tumor after three weeks. The tumor has rapidly increased in size to 6 x 6 x 2 cm and protruded further. (c) The tumor is observed to be continuous with the keloid scar (arrowhead), protruding outside the body, and pedunculated (arrow). (d) Intraoperatively, the tumor had not invaded the abdominal cavity.
case_images: CRIDM2020-4898965.002.jpg
case_images: PMC7397415_01_CRIDM2020-4898965.002.jpg
case_images: fig2
case_images: The tumor rapidly increased in size to 6 x 6 x 2 cm and protruded further in the following two weeks (Figures 2(a)-2(b)). Intraoperatively, the tumor was apparently continuous to the keloid, protruding outside the body, and pedunculated (Figure 2(c)). Furthermore, we observed that the tumor had not invaded the abdominal cavity (Figure 2(d)).
case_images: (a) Gross view of the resected tumor. The tumor is observed to be continuous to the keloid and measures approximately 6.2 x 6 x 3.2 cm. (b) Histopathological examination following hematoxylin and eosin (HE) staining revealing short pleomorphic spindle cells and polygonal cells with a storiform pattern, accompanied by abundant mitotic activity, suggesting undifferentiated pleomorphic sarcoma. The tumor is negative for cytokeratin AE1/AE3 (c) and CAM5.2 (d) on immunohistochemical staining.
case_images: CRIDM2020-4898965.003.jpg
case_images: PMC7397415_01_CRIDM2020-4898965.003.jpg
case_images: fig3
case_images: The resected tumor was continuous to the keloid, measuring approximately 6.2 x 6 x 3.2 cm (Figure 3(a)). Histopathological examination following hematoxylin and eosin staining revealed short pleomorphic spindle cells and polygonal cells with a storiform pattern, accompanied by abundant mitotic activity, similar to the histology obtained on needle biopsy (Figure 3(b)). Moreover, the tumor was negative for smooth muscle actin, h-caldesmon, cytokeratin AE1/AE3, CAM5.2, and CD34 (Figures 3(c)-3(d)), and there was no suspicion of metastasis of the endometrial cancer, suggesting a diagnosis of high-grade UPS.