case_images: PMC6008691_01
case_images: MRI image of a T2-weighted sagittal section. A huge abdominal tumor derived from the uterus, presenting with uneven intratumor signal.
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case_images: fig1
case_images: The tumor showed an uneven signal on T2-weighted sagittal section (Figure 1), and the enhanced MRI study showed that the tumor edge but not the center was enhanced (Figure 2).
case_images: MRI image of a Gadolinium enhanced T1-weighted coronal section. The center of the abdominal tumor was not enhanced, implicating a suspicion of necrosis in the center.
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case_images: fig2
case_images: The tumor showed an uneven signal on T2-weighted sagittal section (Figure 1), and the enhanced MRI study showed that the tumor edge but not the center was enhanced (Figure 2).
case_images: Intraoperative findings of the abdominal tumor. The surgery revealed a huge tumor occupying the space from the pelvis to the diaphragm. The tumor surface was smooth and hard with many dilated veins.
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case_images: fig3
case_images: The tumor surface was smooth and hard with many dilated veins (Figure 3).
case_images: Gross findings of the excised tumor. The size of the tumor was 28 x 23 cm and the weight was 7600g. The tumor showed continuity with the posterior wall of the uterus.
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case_images: fig4
case_images: Macroscopic findings of the tumor revealed a well-circumscribed tumor showing extensive continuity with the posterior wall of the uterus, measuring 28 x 23 cm (Figure 4).
case_images: Macroscopic findings of sections of the tumor. On the sliced surface of the tumor, an obvious heterogeneous pattern was recognized within the mixture of a white homogeneous area, suggesting benign uterine fibroids, and a vulnerable part, due to bleeding and necrosis.
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case_images: fig5
case_images: On the sliced surface of the tumor, an obvious heterogeneous pattern was recognized within the mixture of a whitish homogeneous area, suggesting benign uterine fibroids, and a vulnerable area, due to bleeding and necrosis (Figure 5).
case_images: Microscopic findings of the tumor (H.E. stain; original magnification X40). The tumor was mostly composed of spindle-shaped cells, consistent with degenerated leiomyoma. Enlargement of blood vessels was observed within an area of about 2 cm x several mm, and proliferation of atypical cells showing a fine meshwork microvascular structure was observed in the blood vessel cavity.
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case_images: fig6
case_images: However, enlarged blood vessels were observed within an area of approximately 2 cm x several mm, and proliferation of atypical cells showing a fine meshwork microvascular structure was observed in the blood vessel cavity (Figure 6).
case_images: Microscopic findings of the tumor (H.E. stain; original magnification X400). These atypical cells consisted of various contours, such as cubic, polygonal, and short spindle shape. The nucleus was circular with a high degree of vacuolar enlargement and pleomorphism. Abnormal mitotic figures were also interspersed.
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case_images: fig7
case_images: Abnormal mitotic figures were also interspersed (Figure 7).
case_images: Immunohistochemical findings of the tumor (ERG; original magnification X400). The cytoplasm of the tumor cells was strongly positive for ERG stains.
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case_images: fig8
case_images: Immunohistochemical findings of the tumor (CD31; original magnification X400). The cytoplasm of the tumor cells was diffusely positive for CD31 stains.
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case_images: fig9