case_images: PMC4446482_01
case_images: Pelvic ultrasound. A large hypoechoic mass (asterisk) is seen in the prostatic loggia. The arrow indicates the urinary catheter.
case_images: CRIU2015-419180.001.jpg
case_images: PMC4446482_01_CRIU2015-419180.001.jpg
case_images: fig1
case_images: Pelvic ultrasound (US) showed an 8 x 7.5 x 8.5 cm lesion localized in the prostatic region and behind the bladder with heterogeneous mixed echogenicity (Figure 1).
case_images: CT of the pelvis, enhanced axial image. The asterisk is on the cystic component of the mass. The arrow shows the solid part of the lesion. B = bladder.
case_images: CRIU2015-419180.002.jpg
case_images: PMC4446482_01_CRIU2015-419180.002.jpg
case_images: fig2
case_images: MRI. Axial (a) and sagittal (b) T2-weighted images. Axial precontrast (c) and postcontrast (d) T1-weighted images. The asterisk is on the cystic component of the prostatic lesion; septa are evident. The arrow shows the solid component that improves after Gadolinium injection. Note the presence of a urinary catheter (arrowhead). B = bladder; R = rectum.
case_images: CRIU2015-419180.003.jpg
case_images: PMC4446482_01_CRIU2015-419180.003.jpg
case_images: fig3
case_images: The spindle cells are small, uniform, and closely packed and have a high nuclear-cytoplasmic ratio (a). Immunohistochemical staining showing scattered spindle cells positive for CK AE1/AE3 (b). Diffuse expression of BCL-2 (c) and CD99 (d) in spindle cells.
case_images: CRIU2015-419180.004.jpg
case_images: PMC4446482_01_CRIU2015-419180.004.jpg
case_images: fig4
case_images: The neoplastic cells were closely packed, growing in short interlacing and intersecting fascicles around a branching, "hemangiopericytoma-like vasculature" (Figure 4(a)). Immunohistochemical analysis showed pankeratin expression confined to scattered, individual spindle cells (Figure 4(b)), and diffuse expression of CD56, CD99 (Figure 4(c)), and BCL-2 (Figure 4(d)).
case_images: Photomicrograph of FISH results showing splitting of the fluorescent signal revealing SYT rearrangement.
case_images: CRIU2015-419180.005.jpg
case_images: PMC4446482_01_CRIU2015-419180.005.jpg
case_images: fig5
case_images: The fluorescence in situ hybridization (FISH) test for t(X;18)(p11q11) was positive showing splitting of the fluorescent signal consistent with a rearrangement involving SYT (Figure 5).
case_images: MRI. Postoperative images. Axial T2-weighted (a) and T1-weighted after contrast administration (b) images. Persistence of synovial sarcoma in the prostatic loggia.
case_images: CRIU2015-419180.006.jpg
case_images: PMC4446482_01_CRIU2015-419180.006.jpg
case_images: fig6
case_images: At 3 months of follow-up, after 6 cycles of chemotherapy, pelvic RMI showed persistence of the neoplasm, with cystic and solid component, confined in the prostatic loggia and with invasion of the right prostatic lobe (Figure 6).