PMC3401651_01
(a and b) Axial; and, (c) coronal contrast enhanced CT scan showing the enhancing ASPS in the right frontal calvarium infiltrating into the frontal lobe with perifocal edema
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F1
There was destruction of the overlying bony calvaria and an additional extracalvarial extension of the tumor [Figure 1].
(a and b) Photographs of the patient showing the tumor on the forehead; (c) Following bicoronal incision and scalp elevation, the tumor is exposed; (d) Excision of extradural part of tumor; (e) the scalp being reposited after tumor excision
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F2
The involved dura was excised and after performing a duroplasty using the pericranium, the scalp was closed in layers [Figure 2].
(a) Tumor is disposed in nests and alveolar pattern separated by thin fibrovascular septa. The tumor cells are large with mildy anisomorphic round to oval central to eccentric nuclei, conspicuous nucleoli and eosinophilic granular to dense cytoplasm. Mitotic activity is scant (H and E x400); (b) intracytoplasmic PAS positive granules are seen (PAS-Periodic acid Schiff's x400); (c) On immunohistochemistry tumor cells are positive for S-100 (x200); and, (d) focally positive for desmin (x200)
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F3
Her biopsy revealed an alveolar soft part sarcoma [Figure 3].