case_images: PMC10570615_01
case_images: Magnetic resonance images. (A) Coronal T1-weighted images show that the mass is strip-shaped and iso-hypointense. (B) Coronal T2-weighted images show heterogeneous high intensity. (C) Coronal proton density-weighted fat-suppressed images show a spindle-shaped tumor with clear borders. (D) Sagittal T2-weighted image. (E) Axial fat-suppressed T2-weighted images show heterogeneous density inside the tumor and high intensity around the tumor. (F) Axial T1-weighted image.
case_images: fneur-14-1221912-g0001.jpg
case_images: PMC10570615_01_fneur-14-1221912-g0001.jpg
case_images: F1
case_images: T1-weighted images (Figure 1A) and hyperintensity on T2-weighted images (Figure 1B). The tumor was a 1.9 x 1.8 x 7.5 cm fusiform mass. Adjacent tendons were compressed and displaced (Figures 1C, D). On axial images, the tumor was surrounded by high signal intensity, and there was a heterogeneous signal area in the tumor (Figures 1E, F).
case_images: Histopathological features of the tumor. (A) It is closely related to the surrounding muscles and manifests as a fusiform bulge on the median nerve (arrow) (Note: l: left; r: right; d: distal; p: proximal). (B) The tumor is dissected, and the surface is uniformly gray-white. (C) The tumor cells are arranged in sheets, and cords of plump [hematoxylin and eosin (H&E) stain, x 200]. (D) Entrapped nerve fibers surrounded by tumor (H&E stain, x 100). (E) Necrosis foci (H&E stain, x 100). (F) Granular and intensely eosinophilic cytoplasm and some cytoplasms are vacuolated (H&E stain, x 200). (G) Pustular ovoid body (arrow) (H&E stain, x 400). (H) Tumor cells with multiple mitoses (2/10 HPF) (black arrows) and pleomorphism (white arrow) (H&E stain, x 400).
case_images: fneur-14-1221912-g0002.jpg
case_images: PMC10570615_01_fneur-14-1221912-g0002.jpg
case_images: F2
case_images: The two ends of the tumor grew continuously and had no boundaries with the nerves (Figure 2A). Macroscopically, a gray-white fusiform mass measuring 12.5 x 2.2 x 3.5 cm (Figure 2B) was non-encapsulated, with the muscle attached to the surface. Histopathologically, the tumor was arranged as sheets and cords of plump polygonal cells with abundant eosinophilic granular cytoplasm (Figure 2C). Entrapped nerve fibers were also identified in the tumors (Figure 2D). In addition, necrosis was observed in some areas (Figure 2E). A small portion of the cytoplasm was vacuolated (Figure 2F), and oval eosinophilic bodies surrounded by halos were occasionally observed (Figure 2G). The tumor showed atypical features such as large nuclei with prominent nucleoli, a high nuclear:cytoplasmic ratio, pleomorphism, and multiple mitoses (two mitotic counts per 10 high-power fields) (Figure 2H).
case_images: Histochemical staining. The tumor cells are strongly positive for (A) S-100, (B) SOX10, and (C) Calretinin, and the (D) Ki-67 labeling index is 10% ( x 200).
case_images: fneur-14-1221912-g0003.jpg
case_images: PMC10570615_01_fneur-14-1221912-g0003.jpg
case_images: F3
case_images: The Ki-67 labeling index was 10% (Figure 3D). The pathological diagnosis was an atypical GCT of the median nerve.