Myxoid soft tissue tumor in the loin

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1 J1 Myxoid soft tissue tumor in the loin Atsuji Matsuyama 1, Masamichi Nakayama 2, Masanori Hisaoka 1 1 Department of Pathology & Oncology, School of Medicine, University of Occupational & Environmental Health, Kitakyushu 2 Department of Pathology, St.Mary's Hospital, Kurume, Japan A 70-year-old man was admitted to a hospital because of a mass in the right loin for six months. CT indicated a well-circumscribed subcutaneous mass, measuring 9x7x6 cm. On coronal T1-weighted magnetic resonance (MR) image, the mass showed mixed hyperintensity and hypointensity. After gadolinium administration, the signal enhancement of the mass was intense and heterogeneous. On T2-weighted MR image, the signal of the mass was of hyperintensity and demonstrated central hypointensity. After the initial surgery and the pathological evaluation of the lesion, the wide resection including residual tumor was carried out. The provided slides are those from the specimen of the second operation. CT Coronal T1-weighted MRI Coronal fat-suppressed postcontrast T1-weighted MRI Axial fat-suppressed T2-weighted MRI Keywords : soft tissue, sarcoma, myxoid, trunk, subcutaneous

2 J2 Tumor of the left thigh Hiroaki Suzuki 1, Toshihisa Osanai 2, Tamotsu Soma 2, Hiroaki Hiraga 2, Hiroko Takeda 1, Katsushige Yamashiro 1, Takayuki Nojima 3, Akifumi Ooi 4 Section of Diagnostic Pathology 1, Section of Orthopedics 2, Hokkaido Cancer Center, Sapporo Department of Pathology, Kanazawa Medical University 3, Kanazawa Department of Molecular and Cellular Pathology, Kanazawa University 4, Kanazawa, Japan A 46-year-old woman noticed a mass in the lt. thigh 14 month before. She felt increase of the size of the mass and went to a regional hospital. She visited our hospital. MRI showed the 7 cm sized mass. Lipoma was suspected and the patient was followed-up. After 10 months the size of the tumor increased in the size to 10 cm. Small area (about 1 cm size) was enhanced by MRI (T1W Gd FS) and dedifferentiated liposarcoma was suspected. Surgical resection of the tumor was performed. MRI T1W T2W T1WGdFS

3 J3 Soft tissue tumor of the right thigh Anna Kobayashi 1, Takuya Fujimoto 2, Toshiko Sakuma 1, Takanori Hirose 1 Departments of 1 Diagnostic Pathology and 2 Orthopedics, Hyogo Cancer Center, Akashi, Japan A 44-year-old male presented with a painless mass of his right thigh. Enhanced Magnetic Resonanse Imaging (MRI) revealed T1-high, T2 high solid tumor, 32x22x32 mm in size, within semimembranosus muscle and the long head of biceps femoris muscle. The clinical diagnosis was solitary fibrous tumor. Ultrasound-guided biopsy was performed, and tumor was histologically diagnosed as rhabdomyosarcoma. The wide excision specimen consisted of a multilobular, white mass with relatively clear borders. The patient has remained disease-free for 10 months after the resection and post-operative chemotherapy. T1W1 T2W1

4 J4 Soft tissue tumor of the left gluteus muscle Hiroki Imada 1, Takehiko Yamaguchi 1, Akihiko Yoshida 2 1 Department of Pathology, Dokkyo Medical University Koshigaya Hospital, Koshigaya 2 Department of Pathology, National Cancer Center Hospital, Tokyo, Japan A 62-year-old man had complained of a soft tissue mass in left part of the buttock for four months. Imaging study revealed a well demarcated mass without mineralization in left gluteus maximus muscle, measuring 6x4.5x3 cm in size. Excisional biopsy was performed for histological diagnosis. X-ray T1 WI enhanced T1 WI

5 T2 WI T1 WI Cut surfaces of excised tumor

6 K1 Sang Kyum Kim Department of Pathology, Yonsei University College of Medicine An eleven-month-old male who was born by normal spontaneous vaginal delivery at gestational age of 40 weeks visited our outpatient department for scrotal swelling. The child s parents said that they first noticed scrotal swelling when he was two months old, and that the swelling seemed to gradually become worse. Ultrasonography revealed an ovoid shape, heterogeneously hypoechoic nodule located near to the left spermatic cord, which demonstrated hypervacular signal on Doppler Ultrasonography. The patient underwent tumor excision. On gross examination of the surgical specimen, the tumor was firm and encapsulated by a thin fibrous tissue and the cut surface was homogeneously white. A representative H&E stained slide is provided. [Ultrasonography] [Gross finding]

7 K2 Kyu Sang Lee Department of Pathology, Seoul National University Bundang Hospital, School of Medicine A 45-year-old man presented with the abdominal pain for 6 months and 8 kg of weight loss. One month before admission, the pain was worse. CT scan revealed markedly thicken ileal wall and numerous irregular peritoneal nodules with mesenteric fat reticulations, concerning for acute Meckel's diverticulitis or TB peritonitis or carcinomatosis peritonei. With the impression of adhesive ileus, he underwent segmental resection of ileum and partial omentectomy. The representative section was taken from omental nodule.

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9 K3 Ga-Eon Kim Department of Pathology, Chonnam National University Hostpital A 69 year-old female presented with a noticeable mass in her back and back pain over a one-year period. Magnetic resonance imaging (MRI) revealed a paraspinal mass at L2-3 level, and the patient was referred to Chonnam National Univertisy Hospital. Computed tomography (CT) demonstrated a 5.5 x 4 x 3.5 cm mass involving the right posterior aspect of the L3 with extraosseous mass formation. She underwent surgical excision. The representative section was taken from the mass.

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