J1 Myxoid soft tissue tumor in the loin

Atsuji Matsuyama1, Masamichi Nakayama2, Masanori Hisaoka1

1Department of Pathology & Oncology, School of Medicine, University of

Occupational & Environmental Health, Kitakyushu 2Department 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

J2 Tumor of the left thigh

Hiroaki Suzuki1, Toshihisa Osanai2, Tamotsu Soma2, Hiroaki Hiraga2,

Hiroko Takeda1, Katsushige Yamashiro1, Takayuki Nojima3, Akifumi Ooi4

Section of Diagnostic Pathology1, Section of Orthopedics2, Hokkaido Cancer Center,

Sapporo

Department of Pathology, Kanazawa Medical University3, Kanazawa

Department of Molecular and Cellular Pathology, Kanazawa University4,

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

J3 Soft tissue tumor of the right thigh Anna Kobayashi1, Takuya Fujimoto2, Toshiko Sakuma1, Takanori Hirose1

Departments of 1Diagnostic Pathology and 2Orthopedics, 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

J4 Soft tissue tumor of the left gluteus muscle

Hiroki Imada1, Takehiko Yamaguchi1, Akihiko Yoshida2

1Department of Pathology, Dokkyo Medical University Koshigaya Hospital,

Koshigaya 2Department 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

Cut surfaces of excised tumor

T2 WI T1 WI

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]

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.

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.