Value of contrast-enhanced ultrasound in deep angiomyxoma using a biplane transrectal probe: A case report

Figure 1 Magnetic resonance imaging and contrast-enhanced computed tomography images in our case. A: Preoperative sagittal T2-weighted imaging. The mass (arrows) was 9.5 cm × 8.1 cm in size, showing a layered appearance with alternating high and low signals and a clearly demarcated boundary with respect to surrounding tissue, and the uterus was pushed and displaced cephalad; B: Preoperative transverse contrast-enhanced computed tomography (CECT) showed that the anterior vagina and the right posterior rectum (arrowhead) were pushed by the mass (arrows); C: Six months after surgery, transverse CECT showed that the filled bladder, vagina, and rectum (arrowhead) were in normal positions, with no evidence of tumor recurrence. u: Uterus; v: Vagina; b: Bladder.

Figure 2 Scanning with a TRT33 biplane transrectal probe linear array. A: Grayscale ultrasound showed that the mass (arrows) was irregular in shape, with a layered appearance of alternating hyperechoic and hypoechoic areas inside and a clearly demarcated boundary with respect to the rectal wall (curved arrow); B: Color Doppler flow imaging showed that the dispersed intratumoral blood vessels were consistent with the layered appearance of the mass (arrows) on grayscale ultrasound; C: Transrectal contrast-enhanced ultrasound showed a laminated distribution of the contrast agent in the mass (arrows), also consistent with the layered appearance of the tumor on grayscale ultrasound; D: Transperineal core needle (arrowheads) biopsy was performed under the guidance of transrectal ultrasound.

Figure 3 Pathological results of the deep angiomyxoma puncture sample. A: Small-sized spindled or stellate cells scattered in the myxoid stroma containing many blood vessels of varying caliber, without cellular atypia or mitotic activity (HE × 200); B: Immunohistochemistry showed positive expression of estrogen receptors in the tumor cells (× 200).