Acute Massive Spontaneous Intratumoral Hemorrhage in a Pediatric Atypical Teratoid/Rhabdoid Tumor: A Case Report

The majority of atypical teratoid/rhabdoid tumors (ATRTs) appear as heterogeneous masses with solid, cystic, necrotic components and calcification in the cerebral hemispheres; however, acute hemorrhagic onset is rare. The aim of this study is to describe a patient with an acute hemorrhagic supratentorial ATRT. A 4-year-old patient presented with right-sided weakness, nausea, vomiting, and loss of consciousness. Cranial magnetic resonance imaging revealed a large solid and cystic mass in the left posterior frontotemporal region with evidence of acute hemorrhage. The patient underwent urgent surgery, and gross total excision of the hemorrhagic tumor was achieved. A follow-up brain magnetic resonance imaging performed 2 months after surgery showed no evidence of tumor recurrence. Although hemorrhage is not uncommon in ATRT, massive acute hemorrhagic onset may obscure the underlying neoplasm; therefore, ATRT should be included in the differential diagnosis of spontaneous supratentorial hemorrhage in children.