case_images: PMC7691891_01
case_images: Computed tomography (CT) scan revealed hemoperitoneum (A,
  arrowheads) and a large heterogeneous mass with a nonuniform
  enhancement pattern in the pelvis (B, arrows). A follow-up CT
  scan 12 years after surgery revealed a heterogeneous mass in the
  abdomen (C, arrows).
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case_images: However, 12 years after surgery, follow-up CT revealed a mass 6 cm in diameter in the abdomen (Figure 1C).
case_images: A submucosal tumor of ileum with bleeding was confirmed,
  accompanied by peritoneal metastases (A). Recurrent tumors
  adhered to the greater omentum but were not invasive (B).
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case_images: Laparotomy revealed a 12 x 10 x 6 cm solid tumor in the ileum with bleeding approximately 150 cm from the ligament of Treitz, accompanied by a multitude of peritoneal metastases (Figure 2A). The tumor adhered to the greater omentum but was not invasive (Figure 2B).
case_images: Histology indicated that the primary tumor was composed of spindle
  cells (A). The number of mitoses in the primary tumor was 12 per
  50 high-power fields (HPFs). The histological pictures of the
  recurrent tumor were almost identical to those of the primary
  tumor, and the number of mitoses in the recurrent tumor was 8
  per 50 HPF (B). Ki67 labeling index was 23% and 14% for the
  primary tumor and the recurrent tumor, respectively.
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case_images: Pathological examination showed that the tumor was composed of spindle cells that were arranged in interlaced bundles with high cellularity (Figure 3A). The number of mitoses was 12 per 50 high-power fields (HPFs; Figure 3A). The Ki67 labeling index at the hot spot was 23% (Figure 3B). The number of mitoses was 8 per 50 HPF (Figure 3B). KIT, CD34, and DOG1 and negative for desmin and S-100 protein (images not shown). Ki67 labeling index at the hot spot was 14% (Figure 3B).
case_images: Immunohistochemical staining of primary tumor showing positive
  reactivity for KIT, CD34, and DOG1. There was no expression of
  desmin or S-100 protein.
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case_images: Immunohistochemical staining showed that the spindle cells were diffusely positive for KIT, CD34, and DOG1 and negative for desmin and S-100 protein (Figure 4).