PMC4102603_01
Axial T1 post gadolinium enhanced image of the brain revealing a dural based heterogenously enhancing mass with surrounding vasogenic edema.
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There was visible mass effect on the adjacent brain parenchyma, as well as associated vasogenic edema and effacement of the left lateral ventricle without midline shift (Figure 1).
Histopathological and immunohistochemical findings of the tumor. (A, B) Small round blue cell neoplasm with primitive-appearing and undifferentiated cells displaying mitotic figures (hematoxylin and oesin; 20x and 40x respectively). (C) Strong membraneous positivity with CD99 (20x). (D) Moderate positivity with synaptophysin (20x). (E) Strong positivity with S-100 (20x). (F) Moderate positivity with NSE (20x).
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The findings were consistent with a Ewing sarcoma family tumor (Figure 2). Immunohistochemistry (IHC) staining showed a strong and diffuse positivity for membranous CD99, vimentin, and S100, as well as moderate positivity for synaptophysin and neuron specific enolase (NSE) (Figure 2).