患者男,56岁,农民。发现右侧腹壁无痛性结节并逐渐增大6年余。患者6年前偶而发现右侧腹壁有一小指头大小无痛性结节,日渐增大,局部曾二次红肿,抗炎治疗无效。检查:右侧腹壁有鹅蛋大肿块,质硬,边界不清,1988年5月10日行肿块切除术。肿块位于皮下,向四周及深部浸润,边界不清,切除肿瘤。病理检查:肿块大10×8×6cm,质地坚韧,切面黄白色,未见明显包膜。镜下瘤细胞为多边形,或椭圆形,胞浆丰富,内含均匀一致的伊红颗粒,核膜不清,细胞核小而深染,位于细胞中央,可见核分裂,病理诊断:腹壁恶性颗粒性肌母细胞瘤。手术后4个月,右臀部出现包块,X线摄片 Male patient, 56 years old, farmer. Abdominal painless nodules found on the right side and gradually increased more than 6 years. 6 years ago, patients occasionally found a small finger on the right abdominal wall painless nodules, growing, local had two redness, anti-inflammatory treatment is invalid. Check: The right abdominal wall with oval large mass, hard, unclear boundary, May 10, 1988 line excision. The lumps were located subcutaneously, infiltrated to the periphery and deep, the border was unclear, and the tumor was removed. Pathological examination: mass 10 × 8 × 6cm, tough texture, yellow-white section, no significant capsule. Microscope tumor cells polygons, or oval, rich in cytoplasm, containing homogeneous eosin granules, nuclear membrane unclear, small and deep nuclei, located in the central cell, showing nuclear fission, pathological diagnosis: abdominal malignant granular muscle B cells. 4 months after surgery, the right hip appeared mass, X-ray