Primary intracerebral fibrosarcoma with intraventricular hemorrhage: a case report and literature review

Primary intracerebral fibrosarcomas are rare tumors of mesenchymal origin in the central nervous system (CNS). Fibrosarcoma presenting with spontaneous hemorrhage in the ventricles and without ventricle seeding has not been described in primary cerebral fibrosarcoma. We report the case of a 29-year-old male presenting with spontaneous hemorrhage of a fibrosarcoma that bled into the ventricles. Initially, his condition was considered a cerebral hemorrhage. With the absorption of the hematoma, the clot retracted, but a CT image of the head revealed increased density. The patient was subsequently diagnosed with a tumor. The tumor was completely resected. After 12 months of follow-up, the tumor did not relapse in situ, and no seeding metastasis was observed in the ventricles. Fibrosarcoma is a highly malignant tumor that commonly exhibits recurrence in situ and distant metastasis. The hematoma of the cancer can bleed in the ventricles without implantation metastasis. Furthermore, we examined CD31 and CD68 expression to predict progression-free survival (PFS) and distant metastases-free survival (DMFS). We concluded that fibrosarcoma near the cerebral ventricle can present with a hematoma that can drain into the ventricles. However, fibrosarcoma is often misdiagnosed as a cerebral hemorrhage that has bled into the ventricles. Thus, increased attention must be paid to a tumor that presents with a hematoma in young people.