title: Peripheral primitive neuroectodermal tumor (PPNET) of pelvic origin: report of a case arising from an unusual location.
abstract: We report a rare case of a peripheral primitive neuroectodermal tumor (PPNET) originating from the left ileopsoas muscle in an adult patient with neoplastic thrombosis of the left external iliac vein, the common femoral vein and the left popliteal vein. We performed a median laparotomy with an oblique left inguinal incision to remove the neoplasm, which consisted of a large mass surrounding the iliac-psoas muscles, extending from the transverse apophysis of the spinal column to Scarpa's triangle, and passing through the lacuna musculorum. Histopathological examination revealed a primitive neuroectodermal tumor (PNET) with focal areas of necrosis, hemorrhage and vascular invasion. Immunophenotyping was positive for CD99, NSE, and focally for CK. Ultrastructural examination of the neoplastic cells showed often multiple nuclei with dense chromatin and very large nucleoli. The patient was discharged ten days after the operation. Adjuvant treatment consisted of radiotherapy at a dose of 2000 cGy in five fractions followed by six cycles of chemotherapy. The venous thrombosis was treated by anticoagulant therapy and recanalization of the occluded veins was obtained after two months of therapy. An MRI scan, carried out 12 months later, showed a local relapse, which was treated with chemotherapy and arterial chemoembolization.
authors.affiliation: Department of Surgical Sciences, Division of General Surgery, La Sapienza University, Rome, Italy. vito.dandrea@uniroma1.it
authors.forename: Vito
authors.initials: V
authors.lastname: D'Andrea
authors.forename: Laura
authors.initials: L
authors.lastname: Falvo
authors.forename: Antonio
authors.initials: A
authors.lastname: Catania
authors.forename: Salvatore
authors.initials: S
authors.lastname: Sorrenti
authors.forename: Alberto
authors.initials: A
authors.lastname: Berni
authors.forename: Vito
authors.initials: V
authors.lastname: Cantisani
authors.forename: Paolo
authors.initials: P
authors.lastname: Ricci
authors.forename: Enrico
authors.initials: E
authors.lastname: De Antoni
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000473:pathology* / Q000601:surgery / Q000648:ultrastructure; D010386:Pelvic Neoplasms / Q000473:pathology* / Q000601:surgery / Q000648:ultrastructure; D014057:Tomography, X-Ray Computed