case_images: PMC11153743_01
case_images: Abdominal contrast-enhanced computed tomography of case one. (A) Plain scan shows a large heterogeneous mass (*) with calcification (red solid arrow) at the margins at the end of the ileum measuring 8.7x7.0 cm; (B) Adjacent bowels are pushed by the exophytic, heterogeneous enhanced mass; (C) The artery supplying blood to the mass is from a branch of the superior mesenteric artery and a tortuous draining vein is seen (yellow arrow); (D) Free gas in the abdominal cavity (red hollow arrow).
case_images: fonc-14-1408524-g001.jpg
case_images: PMC11153743_01_fonc-14-1408524-g001.jpg
case_images: f1
case_images: CECT revealed a lobulated, heterogeneously enhancing mass with fibrous separation and extensive necrosis originating from the terminal ileum measuring 8.7x7.0cm ( Figure 1 ), accompanied by a blurring of the adipose space and compression of the neighboring intestinal canal. Calcifications were observed at the periphery of the exophytic mass. Gross examination showed a large white hemorrhagic lesion with a 0.5 cm-sized perforation ( Supplementary Figure S1 ).
case_images: Pathological examination of case one. (A) The tumor with mitotically active spindle-shaped cells with severe diffuse atypia and abundant eosinophilic cytoplasm (16 mitoses per 10 high power fields) (H&E, x400). (B) Fibrous septa and large areas of coagulative necrosis within the tumor (H&E, x40). The tumor cells express (C) Desmin, (D) smooth muscle actin (SMA), and (E) Caldesmon while other markers, (F) DOG1, (G) CD117, (H) CD34, and (I) S-100 are negative (H&E, x100).
case_images: fonc-14-1408524-g002.jpg
case_images: PMC11153743_01_fonc-14-1408524-g002.jpg
case_images: f2
case_images: Figure 2A ). Fibrous septa and large areas of coagulative necrosis were seen inside the tumor ( Figure 2B ). Figures 2C-I ). Finally, the patient has confirmed the diagnosis of low differentiated leiomyosarcoma with negative surgical margins and negative lymph nodes. Histology confirmed that the tumor was immunohistochemically positive for SMA, and desmin, while CD34, CD117, and DOG1 were negative ( Supplementary Figure S2 ).