Figure legends :
Fig 1.
a. MRI showing - Sagittal T2W MRI image shows an intra-axial large solid
-cystic mass measuring 7 cm x 6 cm in the right parafalcine
fronto-parietal lobe, causing ventricular compression. (Case 1)
b. Contrast enhanced axial CT image multiple lobulated bilateral adnexal
lesions and lesions in the pouch of Douglas (asterisk). (Case 2)
c. Post-treatment axial contrast enhanced CT image showing significant
reduction in size and extent of the lesions (asterisk). (Case 2)
d. Residual intermediate T2W signal intensity lesion in the endocervical
canal (asterisk). (Case 3)
e-f. Subsequent T2W sagittal images show increasing size of the
recurrent lesion at the same site (asterick). (Case 3)
Fig 2. H&E
a. Scanner view of the immature cartilage, x 2.5 magnification.
b. Scanner view of the malignant primitive blastemal like small spindle
cells, x 4 magnification.
c. Low power of the subepithelial arrangement of primitive blastemal
like spindle cells x 10 magnification.
d. Low power of the tumour cells showing hypocellular and hypercellular
areas x 10 magnification. Immunohistochemistry with desmin showing
positivity in the spindle cells (inset).
e. Low power view of the immature cellular cartilage admixed with the
spindle cells, x 10 magnification.
f. High power view showing abrupt transition from chondroid to spindle
cells, x 40 magnification.
Fig 3. H&E
a. Scanner view showing the immature cartilage and malignant spindle
cells, x 4 magnification.
b. Low power view showing alternating hypercellular and hypocellular
areas in a myxoid background, x 10 magnification. The spindle cells are
positive for desmin (inset).
c. Low power view showing subepithelial condensation of tumour cells, x
10 magnification.
d. Low power view showing densely packed primitive blastemal cells
showing perivascular condensation of tumour cells, x 10 magnification.
e. Low power view showing tumour cells in nests in a loose myxoid
background, x 10 magnification.
f. High power view of the tumour cells showing coarse chromatin and
mitotic figures, x 40 magnification.
Fig 4.
a. Scanner view of primary tumour showing the mixed pattern, comprising
of hypocellular and hyper cellular areas, x 2.5 magnification.
b. Low power view showing subepithelial concentration of spindle cells,
mimicking a cambium-like layer, x 10 magnification. The spindle shaped
tumour cells are strongly positive for desmin (inset).
c. Low power view showing immature mesenchyme, x 20 magnification.
d. Low power view showing hypercellular foci of larger cells in nests,
cords and showing mitotic figures, x 10 magnification.
e. Low power view showing granular pink neuropil / glia-like area with
rosette formation in the tumour, x 10 magnification.
f. Low power view showing tumour cells arranged in cords, x 20
magnification.
g. Low power of the biopsy from residual tumour showing scattered bland
spindle cells in a loose myxoid background, x 10 magnification.
h. Low power view of recurrent tumour showing sheets of large blastemal
cells x 10 magnification.
i. High power view of the blastemal cells showing opened up nuclear
chromatin and mitoses and apoptosis, x 40 magnification. The blastemal
cells are strongly positive for SALL4 (inset).