case_images: PMC10792281_01
case_images: Magnetic resonance imaging shows an intraosseous metaphyseal central lytic lesion (red arrow), completely replacing the medullary cavity of the distal third of the right femoral shaft for a 10 cm span in craniocaudal dimension with multiple areas of cortical bone destruction.
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case_images: f1-jptm-2023-11-14
case_images: Magnetic resonance imaging showed a well-defined central destructive lesion, completely replacing the medullary cavity of the distal third of the right femoral shaft for a 10 cm span in craniocaudal dimension, reaching the anterior aspect of both femoral condyles and the posterior aspect of the intercondylar fossa with multiple areas of cortical bone destruction (Fig. 1).
case_images: Microscopic and immunohistochemical features of primary bone leiomyosarcoma. (A) Photomicrograph shows fascicles of pleomorphic spindle and epithelioid cells arranged in fascicular, storiform, and haphazard patterns. (B) High-power view demonstrates cellular pleomorphism in the form of hyperchromasia, high nucleus-to-cytoplasmic ratios, and irregular nuclear contours. Some cells show vesicular nuclei and prominent nucleoli. (C) Photomicrograph shows fat lobules infiltrated by tumor cells. (D) The tumor cells are positive for smooth muscle actin. (E) The tumor cells show focal reactivity for Desmin. (F) The tumor cells show focal reactivity for H-caldesmon. (G) The tumor cells are negative for estrogen receptor.
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case_images: f2-jptm-2023-11-14
case_images: There was significant pleomorphism in the form of hyperchromasia, high nucleus-to-cytoplasmic ratio, and irregular nuclear contours, arranged in intersecting, storiform, and haphazard patterns (Fig. 2A, B). Fat lobules infiltrated by the atypical cells were also seen (Fig. 2C). SMA (ready-to-use, Dako, Glostrup, Denmark) "shown in Fig. 2D", focally positive for desmin (readyto-use, Dako) (Fig. 2E), H-caldesmon (ready-to-use, Dako) (Fig. 2F), CD10 (ready-to-use, Dako), CD68 (ready-to-use, Dako) and SATB2 (prediluted, Cell Marque, Rocklin, CA, USA), and negative for cytokeratin (CK) AE1/AE3 (ready-to-use, Dako), CK MNF 116 (1:50, Dako), CDK4 (prediluted, Cell Marque), MDM2 (prediluted, Cell Marque), Melan-A (ready-to-use, Dako), S100 (ready-to-use, Dako), SOX-10 (prediluted, Cell Marque), estrogen receptor (ER; ready-to-use, Dako) (Fig. 2G), progesterone receptor (PR; ready-to-use, Dako), CD31 (ready-to-use, Dako), CD34 (ready-to-use, Dako), and myogenin (ready-to-use, Dako). S100 (ready-to-use, Dako) was positive in the adipocytes.
case_images: A computerized tomography scan of the pelvis reveals no uterine lesions.
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case_images: Imaging studies revealed no uterine masses (Fig. 3) or soft tissue masses, and no lung or bony metastatic lesions.