case_images: PMC9458873_01
case_images: Timeline. A graphic depiction of the timeline of events in this case.
case_images: fped-10-952023-g001.jpg
case_images: PMC9458873_01_fped-10-952023-g001.jpg
case_images: F1
case_images: Her abdomen was noted to be distended and taut with prominent abdominal veins (Figure 1).
case_images: Radiographs. Supine (A) and left lateral decubitus (B) radiographs demonstrated pneumoperitoneum on day of life 3.
case_images: fped-10-952023-g002.jpg
case_images: PMC9458873_01_fped-10-952023-g002.jpg
case_images: F2
case_images: The patient's pediatrician sent the patient to the emergency department where an abdominal X-ray revealed a large volume of pneumoperitoneum concerning for bowel perforation (Figure 2).
case_images: Histological examination of neoplasm. (A) Prominent vasculature is identified within some areas of the spindle cell neoplasm, with several vessels demonstrating a staghorn-like appearance (H&E, scale bar is 200 microns). (B) At higher power, the neoplastic cells are monomorphic, ovoid to spindled, with a moderate amount of cytoplasm and coarse chromatin, and scattered apoptotic bodies are noted (H&E, scale bar is 50 microns). (C) At the site of perforation, the neoplastic cells are seen infiltrating through the muscularis propria and into the serosa and surrounding fibroadipose tissue (H&E, scale bar is 500 microns). (D) These nests of neoplastic cells are away from the main site of perforation and are identified as percolating through the submucosa (H&E, scale bar is 500 microns).
case_images: fped-10-952023-g003.jpg
case_images: PMC9458873_01_fped-10-952023-g003.jpg
case_images: F3
case_images: A microscopic tumor was identified at the site of the perforation (Figure 3).