A rare case of primary cardiac sarcoma with both intracranial metastasis and embolic infarction in a pediatric patient

Figures

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  Fig. 1. Patient’s initial CT head without contrast with a heterogenous parieto-occipital lesion with a 3.8-cm cystic component and a 3-cm solid component and a hyperdense 1.1-cm solid right frontal centrum semiovale lesion with significant surrounding vasogenic edema best demonstrated in the left image

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  Fig. 2. Patient’s initial MRI of the brain (bottom left: T2 FLAIR sequence, all other images T1 post-contrast sequences) further characterizing the left occipito-parietal lesion as mixed cystic and nodular with avid contrast enhancement and mild surrounding vasogenic edema with the ring-enhancing right centrum semiovale mass

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  Fig. 3. MRI brain T1 post-contrast sequence following resection of the parieto-occipital lesion, revealing gross-total resection of the lesion with some enhancing surgical products visible

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  Fig. 4. Preoperative cardiac MRI T2 sequence demonstrates a hypointense lesion filling the majority of the left atrium as well as apical pericardial effusion

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  Fig. 5. MRI brain T1 post-contrast sequence (with poor timing of contrast administration) revealing recurrence of tumor, demonstrated as a nodulocystic lesion in the left parietal lobe

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  Fig. 6. MRI brain T1 post-contrast sequence obtained after re-resection of the lesion, demonstrating gross-total resection

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  Fig. 7. 40× view of the re-resected, predominantly cystic left parieto-occipital lesion showing pleomorphism and vacuolated cytoplasm embedded in a fibrillar background

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  Fig. 8. 20× view of the re-resected predominantly cystic left parieto-occipital lesion showing necrosis

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  Fig. 9. 20× view of the re-resected predominantly cystic left parieto-occipital lesion showing pleomorphism and an abundance of mitotic figures

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  Fig. 10. 40× view of the re-resected predominantly cystic left parieto-occipital lesion showing pleomorphism and an abundance of mitotic figures