PMC7451178_01
Initial presentation of a left occipital lobe intraparenchymal hemorrhage. (a) Head computed tomography without contrast. (b) Axial T1-weighted magnetic resonance imaging (MRI) with contrast. (c) Axial T1-weighted MRI with contrast revealing a left tentorial extra-axial enhancing mass with parenchymal hemorrhage. (d) Baseline axial T1 with contrast before initiation of paclitaxel.
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F1
The ensuing computed tomography (CT) and magnetic resonance imaging (MRI) scans revealed a left occipital lobe hematoma with an underlying left tentorial tumor, suggesting the presence of a cavernous angioma [Figure 1]. Further immunohistochemical studies showed strong immunoreactivity for CD31, CD99, and Fli-1 with a few scattered S100 positive cells but negative for CD34, EMA, desmin, muscle-specific actin, and Bcl-2; the latter findings were suggestive of meningeal sarcoma with angiosarcomatous features, ultimately assessed as a malignant endothelial cell sarcoma/AS [Figure 2 and Table 1].
Neuropathological findings. (a) H&E abnormal blood vessels. (b) CD31 immunoreactive. (c) CD34 abnormal blood vessels. (d) H&E four mitoses in one high power field. (e) H&E brain invasion (squares). (f) Factor VIII faint membrane staining, abnormal blood vessels, and tumor cells.
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F2
Further immunohistochemical studies showed strong immunoreactivity for CD31, CD99, and Fli-1 with a few scattered S100 positive cells but negative for CD34, EMA, desmin, muscle-specific actin, and Bcl-2; the latter findings were suggestive of meningeal sarcoma with angiosarcomatous features, ultimately assessed as a malignant endothelial cell sarcoma/AS [Figure 2 and Table 1].