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).