This is a case of extensive pulmonary metastases that is accidentally discovered by a postoperative CT chest that is done due to chest infection. It shows an angiocentric sign which refers to the vessel directed toward nodule feeding it denoting hematogenous spread. Halo sign in pulmonary metastasis is due to the fragility of neovascular tissue leading to rupture of the vessel.

The Patient undergoes brain surgery but unfortunately, only the extracranial part was excised due to bleeding.  

Pathology of the primary tumor:

Gross picture: A soft grayish-white pink mass measured 7 x 6 cm together with smaller tissue pieces admixed with bony fragments.

Microscopic picture: Highly cellular tumor tissue, made up of diffuse monotonous infiltration by neoplastic small round blue cells, with areas of necrosis and dense desmoplastic stroma. The cytoplasm was scant, granular, and eosinophilic. The nuclei showed granular with irregularly distributed chromatin. soft tissue and bone infiltration were present.

Conclusion: Right temporoparietooccipital SOL, excision biopsy:

Round blue cell neoplasm for immunophenotyping.